Three-Dimensional Printing in Guiding Management of Left Atrial Appendage Occlusion Device Migration

Résumé fourni par la source

BACKGROUND: Left atrial appendage occlusion (LAAO) device migration is rare and may require surgical retrieval. Conventional imaging can be limited in assessing device stability within complex appendage anatomy. CASE SUMMARY: A 79-year-old woman underwent Watchman FLX Pro implantation during atrial fibrillation ablation. At 45 days, computed tomography and transesophageal echocardiography revealed device tilt and a peridevice leak, prompting concern for malposition. Three-dimensional (3D) printing derived from computed tomography showed that approximately 70% of the device was seated and partially endothelialized, suggesting stability. Surgical retrieval was deemed high risk, and the device was left in situ with continued anticoagulation. Six-month imaging confirmed stable position without complications. DISCUSSION: This case demonstrates how 3D printing can clarify ambiguous imaging findings and directly influence management decisions in complex LAAO cases, shifting therapy from surgical intervention to conservative monitoring. TAKE-HOME MESSAGE: When conventional imaging is equivocal, 3D printing provides valuable anatomical insight, supporting personalized, multidisciplinary decision-making.

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