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Percutaneous left atrial appendage suture ligation with the LARIAT® device (Sentre HEART, Redwood City, CA) was successfully performed on an 84-year-old woman with non-valvular atrial fibrillation who developed intracranial hemorrhage on warfarin. However, a large gap developed at follow-up precluding warfarin cessation. To the best of our knowledge, this case report represents the first description of the use of a Gore® Helex® Septal Occluder (W. L. Gore and Associates, Newark, Delaware) as a novel approach to close a gap following percutaneous LAA suture ligation.

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