Gigantic rare left atrial appendage with four lobes closed using a watchman FLX and LAmbre closure device in the kissing technique: a case report.

Abdelrahman Elhakim, Yannick Britt, Mohamed Elhakim, Osama Bisht

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Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Abdelrahman ElhakimCardiology Department, Heart Center Braunschweig, Salzdalumer St. 90, Braunschweig 38126, Germany.ORCID https://orcid.org/0000-0002-3315-4167

Yannick BrittDepartment of Cardiology, Schoen Hospital Neustadt in Holstein, Am Kiebitzberg 10, 23730 Neustadt, Germany.

Mohamed ElhakimIntensive Care Medicine Department, The Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW 2050 Sydney, Australia.ORCID https://orcid.org/0000-0002-4533-160X

Osama BishtInterventional Cardiology Consultant, Heart Center Coswig, Lerchenfeld 1, Coswig (Anhalt) 06869, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Despite the growing experience with left atrial appendage closure and the variety of closure devices and techniques, challenges remain in some cases due to anatomical complexities and varieties. Case summary: We report a case of rare and complex LAA anatomy. Cardiac computed tomography and angiography demonstrated a gigantic LAA with four lobes at the level of the ostium that cannot be occluded by the currently approved LAA closure devices in Europe. Watchman FLX (27 mm plug) and LAmbre (16/22 mm lobe/disc) closure devices in the kissing technique were successfully deployed under fluoroscopy and transoesophageal echocardiogram guidance without procedure-related complications. Discussion: Watchman FLX (plug) and LAmbre (umbrella and disc) Kissing is feasible. The LAmbre device may close very small or large LAAs with anatomical complexity.

Indexed as

Atrial fibrillationCase reportLAmbra occluderLeft atrial appendage closureOral anticoagulationWachman FLX occluder

Identifiers

PMID42273298

DOI10.1093/ehjcr/ytag383

PMCPMC13249114

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.