Catheterization and Cardiovascular Interventions

ORIGINAL ARTICLE - CLINICAL SCIENCE

Incidence, progression, and predictors of left atrial appendage sealing after Watchman FLX device implantation with computed tomographic assessment

Sung-Han Yoon MD

orcid.org/0000-0003-0465-7061

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Department of Medicine, Division of Structural Heart Disease, Hackensack University Medical Center, Hackensack, New Jersey, USA

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Joseph Kofi Amoah MD,

Joseph Kofi Amoah MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Jason Galo MD,

Jason Galo MD

orcid.org/0000-0001-9036-7049

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Luis Augusto Palma Dallan MD,

Luis Augusto Palma Dallan MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Mauricio Arruda MD,

Mauricio Arruda MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Imran Rashid MD, PhD,

Imran Rashid MD, PhD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Sanjay Rajagopalan MD,

Sanjay Rajagopalan MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Steven J. Filby MD,

Corresponding Author

Steven J. Filby MD

[email protected]

orcid.org/0000-0001-8364-1732

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Correspondence Steven J. Filby, MD, Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA.

Email: [email protected]

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Sung-Han Yoon MD,

Sung-Han Yoon MD

orcid.org/0000-0003-0465-7061

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Department of Medicine, Division of Structural Heart Disease, Hackensack University Medical Center, Hackensack, New Jersey, USA

Search for more papers by this author

Joseph Kofi Amoah MD,

Joseph Kofi Amoah MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Search for more papers by this author

Jason Galo MD,

Jason Galo MD

orcid.org/0000-0001-9036-7049

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Search for more papers by this author

Luis Augusto Palma Dallan MD,

Luis Augusto Palma Dallan MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Mauricio Arruda MD,

Mauricio Arruda MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Imran Rashid MD, PhD,

Imran Rashid MD, PhD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Sanjay Rajagopalan MD,

Sanjay Rajagopalan MD

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

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Steven J. Filby MD,

Corresponding Author

Steven J. Filby MD

[email protected]

orcid.org/0000-0001-8364-1732

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA

Correspondence Steven J. Filby, MD, Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA.

Email: [email protected]

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First published: 25 April 2024

https://doi.org/10.1002/ccd.31044

Citations: 1

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Abstract

Background

Limited data exists regarding incidence, progression, and predictors of left atrial appendage (LAA) sealing after transcatheter LAA closure. We aimed to evaluate the incidence, progression, and predictive factors associated with LAA sealing after LAA closure.

Methods

This study includes patients who underwent successful LAA closure with Watchman FLX device and had both pre- and postprocedural computed tomography (CT). Postprocedural CT was performed 45 days after LAA closure and used to evaluate residual LAA patency. Patient who had residual LAA patency at 45 days underwent 1-year follow-up CT.

Results

A total of 105 patients (mean age: 75.2 ± 9.6 years; 53.3% female) who underwent successful LAA closure with Watchman FLX device and had pre- and postprocedural CT at 45 days were included. Residual patency was observed in 35 (33.3%) patients: 21 (20.0%) patients showed complete contrast opacification in LAA (complete LAA patency) while 14 (13.3%) patients showed contrast opacification only in the distal LAA (distal LAA patency). Among patients with residual LAA patency at 45 days, the rate of LAA sealing at 1 year was significantly higher in the distal LAA patency group than in the complete LAA patency group (75.0% vs. 16.7%; p = 0.019). Increased depth oversizing was associated with both distal LAA patency and complete LAA patency.

Conclusion

Postprocedural CT at 45 days detected patent LAA in one-third of patients after LAA closure. LAA sealing was more frequently observed at 1 year among the distal LAA patency group than the complete LAA patency group.

CONFLICT OF INTEREST STATEMENT

Dr. Steven J. Filby is a consultant and proctor Boston Scientific. The remaining authors declare no conflict of interest.

Open Research

DATA AVAILABILITY STATEMENT

The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study.

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Volume103, Issue6

May 1, 2024

Pages 995-1003

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Incidence, progression, and predictors of left atrial appendage sealing after Watchman FLX device implantation with computed tomographic assessment

Abstract

Background

Methods

Results

Conclusion

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Information

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Incidence, progression, and predictors of left atrial appendage sealing after Watchman FLX device implantation with computed tomographic assessment

Abstract

Background

Methods

Results

Conclusion

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Related

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