Surgical Findings of Iatrogenic Aortic Regurgitation After Percutaneous Left Atrial Appendage Device Retrieval

BACKGROUND: Device dislodgment during percutaneous left atrial appendage occlusion is a rare but challenging complication. Although both catheter-based and surgical retrieval have been described, the optimal strategy remains unclear. CASE SUMMARY: A 57-year-old man developed severe aortic regurgitation after transcatheter retrieval of a left atrial appendage occlusion device that had embolized into the left ventricle. He subsequently underwent minimally invasive aortic valve replacement. DISCUSSION: Transcatheter retrieval of a dislodged device from the left ventricle poses significant risk. Manipulation across the aortic valve may cause valvular injury, as in this case. Early surgical consultation is essential, because surgical retrieval provides direct visualization and controlled management of cardiac structures, with the option for concomitant left atrial appendage occlusion. TAKE-HOME MESSAGE: When device embolization into the left ventricle occurs, early surgical evaluation is advised to minimize valve injury and ensure safe management.