Early Healing After Left Atrial Appendage Occlusion Confirmed by Surgical Explantation

BACKGROUND: Healing of left atrial appendage (LAA) occlusion devices is believed to occur over several months; however, direct histological confirmation in humans remains limited. CASE SUMMARY: An elderly patient underwent LAA occlusion and subsequently required total arch replacement 3 months later because of progressive aortic pathology. The device had previously been noted to have suboptimal positioning. Surgical explantation provided a rare opportunity for direct tissue evaluation. Histological examination demonstrated fibrous tissue coverage over the portion of the device in contact with the LAA wall, whereas the atrial-facing filter surface showed no tissue coverage. DISCUSSION: This case provides rare direct histological evidence of early fibrous tissue coverage after LAA occlusion and offers unique insight into the biological healing process after device implantation. TAKE-HOME MESSAGE: Early fibrous coverage after LAA occlusion may occur within 3 months, as demonstrated by surgical explantation.