case_images: PMC11188374_01
case_images: (A) A fluoroscopic image of a 34 mm LACbes device deployment in the LAA shows that the device is well-positioned with no significant residual shunting. Postoperative angiography confirmed this, and the tug test indicated good stability of the LACbes device. (B) Echocardiography reveals a migrated LAAO within the LA, with an arrow indicating its floating position.
case_images: fcvm-11-1364376-g001.jpg
case_images: PMC11188374_01_fcvm-11-1364376-g001.jpg
case_images: F1
case_images: TEE and angiography revealed that the LACbes device was well-positioned with no significant residual shunting, and the tug test indicated good stability of the LACbes device (Figure 1A). The patient was then transferred to the intensive care unit. A follow-up cardiac ultrasound showed a strong echo from the occluder within the left atrium, swaying with the cardiac cycle (Figure 1B).
case_images: (A) During the performance of the procedure, fluoroscopic imaging showed that the LACbes device was observed to float in sync with the cardiac cycle within the LA. (B) A fluoroscopic image shows a guidewire (Runthrough NS) passing through the LACbes device mesh into the left upper pulmonary vein. (C) A fluoroscopic image shows the use of a gooseneck snare to capture the distal end of the guidewire (Runthrough NS), thus securing the LACbes device within the LA. (D) A fluoroscopic image shows the use of foreign body forceps to gently grasp and retract the LACbes device until it fully withdraws into the ProMedical 16F guiding sheath. The arrows indicate that the LACbes device has been successfully retracted into the ProMedical 16F boot sheath.
case_images: fcvm-11-1364376-g002.jpg
case_images: PMC11188374_01_fcvm-11-1364376-g002.jpg
case_images: F2
case_images: The LACbes device was observed floating in the LA with the cardiac cycle during the procedure (Figure 2A). To clamp the center of the occluder accurately, it was necessary to stabilize the drifting LACbes device within the LA by a guidewire (Runthrough NS) through its mesh into the left upper pulmonary vein (Figure 2B). A gooseneck snare was then used to capture the distal end of the guidewire, thereby securing the LACbes device within the LA (Figure 2C). Finally, an endoscope was advanced through this sheath and foreign body forceps were used to gently grasp and retract the LACbes device until it was fully withdrawn into the ProMedical 16F guiding sheath (Figure 2D).
case_images: A timeline with relevant data obtained from the episode of care.
case_images: fcvm-11-1364376-g003.jpg
case_images: PMC11188374_01_fcvm-11-1364376-g003.jpg
case_images: F3
case_images: The timeline of the patient's management during hospitalization is summarized in Figure 3.