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It was reported that a pericardial effusion and cardiac tamponade occurred.During a watchman left atrial appendage closure (laac) procedure, a versacross connect kit was selected for use.The transseptal puncture was performed and watchman device was implanted successfully.Approximately six to seven hours post procedure, the patient developed a pericardial effusion and cardiac tamponade.Pericardiocentesis was performed to drain the effusion, and the patient was kept overnight for monitoring.One day post procedure, the physician informed that the drain would not pull any more fluid from the effusion site.The patient was expected to fully recover.The device is not expected to be returned for analysis.It was further confirmed that there was substantial difficulty in crossing the septum because of tortuous anatomy in the inferior vena cava (ivc) and getting the preferred angle on the septum was not possible so a more posterior than usual transseptal puncture was performed.The physician was concerned that this was the cause of the effusion simply because the effusion seemed to manifest many hours later, but he still considers it a possibility.There were multiple attempts required to track up / drop down into position on septum.No imaging issues noted.The wire had a clear tent but it was very posterior and looked to be through thicker tissue than the usual/ideal fossa ovalis.The physician felt that because obtaining even that suboptimal position was quite difficult, this was the best he could do and opted to cross despite being very posterior.Act was above 200 seconds.No malfunctions noted with versacross device.
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