Pulmonary artery perforation by atrial appendage closure device and the contribution of auricular contraction to its pathogenesis.

Abstract We report the case of an 83-year-old man with paroxysmal atrial fibrillation who underwent successful percutaneous left atrial appendage closure with the LAmbre device, being in sinus rhythm at implantation. Suddenly, the patient experienced cardiac tamponade and died within a few minutes. Autopsy revealed a slight protrusion of the LAmbre device into the atrial appendage wall and pulmonary artery (PA) laceration. This is the first published report of PA perforation by the LAmbre device. This event highlights the need for a detailed imaging study before this procedure to take account of left atrial appendage movement/contraction in patients in sinus rhythm.