Closing gigantic left atrial appendage using a LAmbre Closure System: First implant experience in North America
Taku Inohara, Michael Tsang, Christopher Lee, Jacqueline Saw
Abstract
INTRODUCTION: Despite maturing experience and growing procedural familiarity, there remain challenges in percutaneous left atrial appendage (LAA) closure due to anatomical complexities. METHODS: We report a complex and extremely large LAA that was successfully closed percutaneously using a LAmbre Closure System (Lifetech Scientific Corp.). Cardiac computed tomography angiography demonstrated a gigantic multilobed LAA measuring 48 × 45.3 mm at the level of the ostium that cannot be occluded by the currently approved LAA closure devices in Canada. RESULTS: The manufacturer custom-made a LAmbre 30/50 mm (lobe/disc) device to fit this patient's LAA according to his CTA, which was successfully deployed under fluoroscopy and transesophageal echocardiogram guidance without procedure-related complications. CONCLUSION: The LAmbre device may be considered to close very large LAAs.