LAUSR

https://e-kcj.org A 79-year-old woman in permanent atrial fibrillation with CHA2DS2-VASc score 6 and under acenocumarol therapy was referred to our department for percutaneous left atrial appendage (LAA) closure after suffering a hemorrhagic cerebrovascular accident. Transesophageal echocardiography (TEE) revealed a thrombus in LAA (Figure 1). We planned to implant LAmbreTM (Lifetech Scientific Corp., Shenzhen, China) with simultaneous use of a cerebral protection device, SentinelTM (Claret Medical, Santa Rosa, CA, USA) (Figure 2). The procedure was guided by TEE without any contrast injection. A partial umbrella delivery of a LAmbre 24/30 mm was done in front of LAA ostium and the whole system was advanced up to the point immediately before thrombus in LAA superior lobe. At this point, the umbrella delivery was completed and afterward the cover part was immediately unsheathed (Figure 3). TEE revealed a proper position of LAmbre, so the device was eventually released (Figure 4). SentinelTM did not contain any debris. The patient's postoperative course was uneventful. Korean Circ J. 2020 Mar;50(3):281-283 https://doi.org/10.4070/kcj.2019.0305 pISSN 1738-5520·eISSN 1738-5555