The second patient was investigated by his G.P. at the age of 34 in 1952. He had been married for 14 vears with no children. A phvsical examination was normal, as was his sexual function. No abnormalities had been found when his wife was investigated in 1946. In 1968 he was referred from his G.P. with a three-week history of diarrhoea. Faecal fats were 22 g/dy, and jejunal biopsy showed subtotal villous atrophv. He was diagnosed as having coeliac disease and started on a gluten-free diet. In 1973 a repeat jejunal biopsy showed normal histology.

Left atrial appendage (LAA) occlusion device implantation is becoming a more common alternative for stroke prophylaxis in patients with nonvalvular atrial fibrillation (AF) who are not able to tolerate long-term anticoagulation. Studies suggest the procedure has a 98.5% successful deployment rate (Boersma et al., 2016). We present a case where a rare but known complication involving dislodgement and migration of an implanted Watchman LAA occlusion device led to functional stenosis of the aortic valve creating a left ventricular outflow tract (LVOT) obstruction necessitating emergency cardiopulmonary bypass in the electrophysiology lab to safely retrieve the device.