I read with interest the manuscript by Masroor and co-authors on the strategy of surgical repair for left atrial appendage perforation following implantation of Watchman device. The authors present the successful management of this complications and they comment on the preferred therapeutic strategy. This is a particular sensitive subject nowadays, since the widespread use and the constant growth of a variety of transcatheter cardiac interventions has inevitably increased the number of patients who are exposed to this type of complication.