Asymptomatic migration of an AMPLATZER™ Amulet™ left atrial appendage occluder through the mitral valve.

An 84-year-old woman with a history of hemorrhagic stroke was admitted for a new cerebral ischemic event. While in hospital, she was diagnosed with paroxysmal atrial fibrillation. Owing to her high thromboembolic risk (CHA2 DS2 -VASc score of 6) we performed left atrial appendage (LAA) closure using a 22-mm AMPLATZER™ Amulet™. The procedure was successful. Systematic follow-up with transthoracic echocardiography 8 hr later revealed that the LAA occluder had migrated and become entrapped in the mitral subvalvular apparatus. At this time, the patient was asymptomatic. The device was recovered percutaneously using a loop-snare catheter, with no further complications.