{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:05:38Z","timestamp":1777352738025,"version":"3.51.4"},"reference-count":14,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,10,29]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>Non-valvular atrial fibrillation (NVAF) is the most common cause of cardioembolic stroke. The left atrial appendage (LAA) is the major source of cardiac emboli in patients with NVAF. Anticoagulation (AC) is the standard of care for stroke prevention in atrial fibrillation (AF), but many patients are intolerant of AC. Surgical exclusion of the LAA may result in incomplete closure and is associated with an increased risk of embolism. We report a case of a woman in her 50s with a history of persistent AF, mitral valve prolapse s\/p repair with surgical LAA exclusion, and multifocal haemorrhagic stroke presented for elective LAA closure who underwent a Watchman placement successfully. This case demonstrates that a percutaneous approach for occlusion of the LAA when surgical exclusion was incomplete may be feasible with appropriate planning. Clinical outcome data for this patient group are needed.<\/jats:p>","DOI":"10.1136\/bcr-2022-251905","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T11:36:00Z","timestamp":1668512160000},"page":"e251905","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Left atrial appendage occlusion with Watchman device after incomplete surgical ligation"],"prefix":"10.1136","volume":"15","author":[{"given":"Ngoda","family":"Manongi","sequence":"first","affiliation":[{"name":"Internal Medicine, NewYork-Presbyterian Queens, Flushing, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Volodarskiy","sequence":"additional","affiliation":[{"name":"Cardiology, NewYork-Presbyterian Queens, Flushing, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Goldbarg","sequence":"additional","affiliation":[{"name":"Cardiology, NewYork-Presbyterian Queens, Flushing, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,15]]},"reference":[{"key":"2025082713173100000_15.11.e251905.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.064"},{"key":"2025082713173100000_15.11.e251905.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00765-8"},{"key":"2025082713173100000_15.11.e251905.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.028"},{"key":"2025082713173100000_15.11.e251905.4","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1007\/s11239-020-02291-5","article-title":"The relationship between incomplete surgical obliteration of the left atrial appendage and thromboembolic events after mitral valve surgery (from the isolate registry)","volume":"51","author":"G\u00fcner","year":"2021","journal-title":"J Thromb Thrombolysis"},{"key":"2025082713173100000_15.11.e251905.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.82.5.547"},{"key":"2025082713173100000_15.11.e251905.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.022"},{"key":"2025082713173100000_15.11.e251905.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.067"},{"key":"2025082713173100000_15.11.e251905.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.06.046"},{"key":"2025082713173100000_15.11.e251905.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.09.054"},{"key":"2025082713173100000_15.11.e251905.10","doi-asserted-by":"crossref","first-page":"141","DOI":"10.21037\/atm.2017.02.17","article-title":"Incomplete surgical ligation of the left atrial appendage-time for a new look at an old problem","volume":"5","author":"Aryana","year":"2017","journal-title":"Ann Transl Med"},{"key":"2025082713173100000_15.11.e251905.11","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV6I2A35"},{"key":"2025082713173100000_15.11.e251905.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.067"},{"key":"2025082713173100000_15.11.e251905.13","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2174\/1573403X11666150805115822","article-title":"Left atrial appendage closure -The Watchman device","volume":"11","author":"Akinapelli","year":"2015","journal-title":"Curr Cardiol Rev"},{"key":"2025082713173100000_15.11.e251905.14","doi-asserted-by":"publisher","DOI":"10.4244\/EIJY15M01_06"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:17:36Z","timestamp":1756325856000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":14,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,15]]},"published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1136\/bcr-2022-251905"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251905","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]}}}