Residual leak following left atrial appendage occlusion with lariat closed with amplatzer PFO occluder device.

Background: Leaks from incomplete ligation of the left atrial appendage (LAA) following closure with Lariat device are not uncommon and associated with higher stroke rate. Clinical vignette: This clinical vignette highlights a procedure of closure of residual leak following closure with Lariat device. There was a persistent central leak of 3-4 mm with bidirectional flow, confirmed on TEE. The Amplatzer Talisman PFO Occluder was chosen for the closure of the leak because of its asymmetric discs with a smaller distal disc and expandable waist.

Conclusion: In situations where the options are limited for PDL closure, such as the one described in this vignette, it is paramount to continue to find innovative solutions to emerging challenges in transcatheter interventions.