Abstract
A 68 year's old man with permanent atrial fibrillation, underwent a left atrial appendage closure because of high bleeding risk. However, after one month, an incomplete occlusion of the left atrial appendage due to a too deep position of the device, was detected by a transesophageal echocardiogram. Considering the residual high risk of thrombi formation, a new different device was successfully implanted with a correct closure of the appendage.