Massive hemoptysis after left atrial appendage occlusion in a patient with atrial fibrillation and left atrial appendage thrombus: a case report

We report the case of an 86-year-old male with atrial fibrillation and a persistent left atrial appendage thrombus despite prolonged oral anticoagulation therapy. The patient successfully underwent intracardiac echocardiography-guided left atrial appendage occlusion with the thrombus in situ. However, he developed a rare but serious complication-massive hemoptysis. The patient then underwent bronchial artery angiography with successful embolization of the dilated bronchial arteries. Following the procedure, the hemoptysis was effectively controlled without any sequelae, and no complications were observed during six months of follow-up.As LAAO technology becomes more widely adopted, clinicians should remain vigilant for rare but life-threatening complications and be prepared for immediate intervention.