Left atrial appendage perforation with Watchman device implantation: Strategies for surgical repair

2020 ◽  
Vol 36 (1) ◽  
pp. 398-400 ◽  
Author(s):  
Saqib Masroor ◽  
Qiong Qiu ◽  
Mohamad Alghothani ◽  
Rajesh Gupta ◽  
George V. Moukarbel
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Surgical Repair ◽  
Atrial Appendage ◽  
Device Implantation ◽  
Watchman Device

Minimally Invasive Thoracoscopic Exclusion of the Left Atrial Appendage Following Watchman Device With an AtriCure ProV LAA Exclusion Device

2019 ◽  
Vol 14 (6) ◽  
pp. 509-511 ◽  
Author(s):  
Matthew A. Romano
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Residual Flow ◽  
Device Implantation ◽  
Watchman Device

This is a case report of a minimally invasive exclusion of the left atrial appendage with a ProV AtriClip following a Watchman device implantation with residual flow into the left atrial appendage.

scholarly journals Antithrombotic Dilemmas after Left Atrial Appendage Occlusion Watchman Device Placement

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tania Ahuja ◽  
Scarlett Murphy ◽  
Daniel J. Sartori
Keyword(s):  
Antithrombotic Therapy ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Device Implantation ◽  
Watchman Device ◽  
Device Placement

Antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF) has dramatically shifted from warfarin, a vitamin K antagonist, to the direct oral anticoagulants (DOACs) such as dabigatran, apixaban, and rivaroxaban. In patients with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) devices, such as the Watchman™ device, may be considered; however, temporary postimplantation antithrombotic therapy is still a recommended practice. We present a case of complex antithrombotic management, post LAAO device implantation, designed to avoid drug interactions with concomitant rifampin use and remained necessary secondary to subsequent device leak. This case highlights the challenges of antithrombotic therapy post LAAO device placement in a complex, but representative, patient.

scholarly journals IMPACT OF RESIDUAL LEFT ATRIAL APPENDAGE TRABECULATIONS AFTER WATCHMAN DEVICE IMPLANTATION IN ATRIAL FIBRILLATION PATIENTS

2017 ◽  
Vol 69 (11) ◽  
pp. 1126
Author(s):  
Krissada Meemook ◽  
Shunsuke Kubo ◽  
Yoshifumi Nakajima ◽  
Mamoo Nakamura ◽  
Asma Hussaini ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Device Implantation ◽  
Watchman Device

scholarly journals 475 Is left atrial appendage device compression rate a predictor of incomplete occlusion in patients undergoing watchman device implantation?

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Michele Magnocavallo ◽  
Domenico Giovanni Della Rocca ◽  
Carlo Lavalle ◽  
Cristina Chimenti ◽  
Gianni Carola ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Imaging Modality ◽  
Accurate Method ◽  
Atrial Appendage ◽  
Device Implantation ◽  
Watchman Device ◽  
Device Size ◽  
Original Device

Abstract Aims Transesophageal echocardiography (TEE) is a standard peri-procedural imaging modality in patients undergoing percutaneous left atrial appendage (LAA) occlusion. An accurate device sizing is pivotal to assess stability and achieve successful closure. In this prospective study, we sought to evaluate the correlation between Watchman device compression rates (DCRs) and risk of incomplete LAA occlusion at follow-up in patients undergoing Watchman device implantation. Methods and results Two-dimensional TEE via a commercially available transducer (Vivid, Philips) was performed during the procedure and within 3 months after the procedure. LAA size, morphology, and DCRs [(original device size—size after deployment)/original device size; %] were assessed in a mid-oesophageal view at 0°, 45°, 90° and 135°, according to company recommendations. Residual leaks ≥ 3 mm were classified as significant. Between 2016 and 2018, 116 patients underwent LAA occlusion with a Watchman device at our institution. The mean age was 74 ± 9 years and 60.4% (n = 70) were males. The average CHA2DS2-VASc and HAS-BLED scores were 4.7 ± 1.7 and 2.5 ± 1.1, respectively. The final device size was 21 mm in 11 (9.5%) patients, 24 mm in 28 (24.1), 27 mm in 27 (23.3%), 30 mm in 26 (22.4%), and 33 mm in 24 (20.7). At follow-up TEE, 16 (13.8%) patients were found to have a significant (≥3 mm) residual leak. The average DCRs measured at different angles in patients with and without leak were not significantly different (24 ± 8% vs. 26 ± 7% at 0°, P = 0.47; 23 ± 9% vs. 25 ± 7% at 45°, P = 0.58; 23 ± 8% vs. 23 ± 6% at 90°, P = 0.61; 22 ± 8% vs. 21 ± 7% at 135°, P = 0.61). At receiver operating characteristic (ROC) analysis, the areas under the curve to discriminate between patients with/without leak were 0.58, 0.57, 0.55, and 0.46 for DCRs measured at 0°, 45°, 90°, and 135° angles. Conclusions Peri-procedural assessment of DCRs does not appear to be an accurate method to predict LAA complete occlusion in patients undergoing Watchman device implantation.

scholarly journals Left atrial appendage closure device complicated by late-onset pericardial effusion and tamponade: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Stefano Albani ◽  
Nicola Berlier ◽  
Francesco Pisano ◽  
Paolo Scacciatella
Keyword(s):  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Late Onset ◽  
Oral Anticoagulants ◽  
Bleeding Risk ◽  
Atrial Appendage ◽  
Closure Device ◽  
Device Implantation ◽  
First Case

Abstract Background Late-onset complications of left atrial appendage occlusion (LAAO) device procedure are anecdotal and there are no such complications reported in literature using Cardia Ultraseal (Cardia, Inc., Eagan, MN, USA). Case summary We report the case of a 74-year-old Caucasian man affected by paroxysmal atrial fibrillation with significant bleeding risk (familiar thrombocytopenia, macroscopic haematuria episodes during therapy with direct oral anticoagulants, HAS-BLED risk score: 4) and ischaemic risk as well (CHADSVASC score: 3). The patient was treated with LAAO device implantation for high bleeding risk. Subsequently, after 26 days from LAAO procedure, he was admitted to the emergency department for haematic cardiac tamponade. The patient was successfully treated with subxyphoidal pericardiocentesis in the acute phase, unfortunately cardiac arrest occurred during the transfer to the referral hospital for urgent cardiac surgery. Permanent neurological damage was reported and the patient died on day 28. Discussion LAAO late-onset complications are very rare and the case presented is the first case described of late-onset pericardial effusion and tamponade secondary to the Cardia Ultraseal LAAO device implantation. We present a revision of the literature regarding the occurrence of similar adverse events and discuss the hypothetical mechanism of this major complication.

scholarly journals PERIDEVICE LEAK AND DEVICE SIZING IN PATIENTS RECEIVING LEFT ATRIAL APPENDAGE CLOSURE WITH THE WATCHMAN DEVICE

2021 ◽  
Vol 77 (18) ◽  
pp. 955
Author(s):  
Lauren Sharan Ranard ◽  
Elena Donald ◽  
Shmuel Chen ◽  
Omar Khalique ◽  
Nadira Hamid ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Watchman Device
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