case_images: PMC11378705_01
case_images: Transesophageal echocardiography post-WATCHMAN device implantation. Echocardiogram showing WATCHMAN device (red dotted line) in place after implantation.
case_images: mdcvj-20-1-1414-g1.jpg
case_images: PMC11378705_01_mdcvj-20-1-1414-g1.jpg
case_images: F1
case_images: A 72-year-old female with past medical history of atrial fibrillation, pacemaker placement, hypertension, CHA2DS2-VASc score of 6, HAS-BLED score of 4, and two prior embolic occipital strokes despite therapeutic anticoagulation underwent placement of a WATCHMAN FLX 35 mm at an outside institution (Figure 1). TEE, the device was noted to have migrated proximally. There was no apparent communication between the left atrium and LAA by color Doppler; however, it appeared to be anchored by only one superior anchor while encroaching into the left atrium and mitral apparatus (Figure 2, Video 1).
case_images: Transesophageal echocardiography (TEE) at 2-week follow-up post-WATCHMAN device implantation. (A) Echocardiogram showing the WATCHMAN device (red dotted line) encroaching onto the mitral apparatus (red arrow pointing to posterior mitral leaflet). Blue arrow points to semilunar valves of the aorta, and yellow lines outline the walls of the left ventricle. (B) TEE 3-dimensional reconstruction of the WATCHMAN device inside the left atrium.
case_images: mdcvj-20-1-1414-g2.jpg
case_images: PMC11378705_01_mdcvj-20-1-1414-g2.jpg
case_images: F2
case_images: TEE, the device was noted to have migrated proximally. There was no apparent communication between the left atrium and LAA by color Doppler; however, it appeared to be anchored by only one superior anchor while encroaching into the left atrium and mitral apparatus (Figure 2, Video 1).