Death from pulmonary artery erosion complicating implantation of percutaneous left atrial appendage occlusion device

Abstract

A 72-year-old woman with paroxysmal atrial fibrillation (CHA2DS2-VASc score = 6) underwent percutaneous left atrial appendage (LAA) occlusion. Comorbidity included diabetes mellitus, hypertension, coronary artery disease, and mild left ventricular dysfunction. A permanent pacemaker had been implanted previously for tachy-brady syndrome. A drug-eluting stent had been implanted to treat an ostial left circumflex coronary artery stenosis. The proximal end of the stent protruded into the distal left main coronary artery, and this was considered an indication for long-term dual antiplatelet agents. Percutaneous LAA occlusion was requested by the treating physician to avoid the need for warfarin and dual antiplatelet agents.