Left Atrial Appendage Occlusion Device Buckling: An Avoidable Deployment Complication Identified and Corrected Using Intraprocedural Transesophageal Echocardiography.

• Watchman device buckling is a previously undescribed deployment complication. • Both 2D and 3D TEE assist in detection of buckling during and after the procedure. • Challenging LAA anatomy may play a significant role in buckling risk. • An acute angle between the deployment catheter and the LAA ostium may confer risk. • With diligent TEE guidance, buckling may be corrected during the procedure.