Prevention and Management of Complications

Abstract

The left atrial appendage (LAA) is a highly variable, delicate cardiac structure. A transseptal puncture is needed in order to perform percutaneous LAA closure and, being a blind-ended structure, the LAA cannot be accessed with over-the-wire techniques. The LAA is part of the left heart circulation so embolization of thrombi, air or other material may have devastating effects for the patient. LAA closure was initially a complication-prone procedure but growing experience shared throughout the interventional community has dramatically reduced such events. The most common procedural complications are pericardial effusion/tamponade, thrombus formation, device embolization, air embolization, and vascular complications. Thrombosis on the surface of the device is the most common complication at follow-up, followed by late pericardial effusion and late device embolization.