Author + information
- Grzegorz Smolka1,
- Marcin Demkow2,
- Radoslaw Pracon3,
- Wojtek Wasek4,
- Adam Sukiennik5,
- Wiktor Kuliczkowski6,
- Wojtek Wojakowski1 and
- Marek Grygier7
- 1Third Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- 2The Cardinal Stefan Wyszynski Institute of Cardiology, warszawa, Poland
- 3Institute of Cardiology in Warsaw, Warsaw, Poland
- 4Military Medical Institute, Warsaw, Poland
- 5Department of Cardiology Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
- 6Wroclaw Medical University, Wrocław, Poland
- 7Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
The safety of dual antiplatelet therapy (DAPT) as an alternative to warfarin plus aspirin after transcatheter closure of left atrial appendage (LAA) with a Watchman device (Boston Scientific, USA) is not well established.
272 subjects, 99 women (39.9%), on DAPT (clopidogrel 75 mg q.d. plus apirin 150 mg q.d.) only after LAA device closure, were selected from 423 consecutive patients enrolled in a prospective, multi-center Watchman registry. In this subgroup median values for age was 73 (IQR 66,75 - 79), for CHA2DS2Vasc 4 (IQR 3 - 5) and for HASBLED 3 (IQR 3 – 4). Median size of implanted device was 27 mm (IQR 24 – 30) with mean compression of 21% (+/- 8%). There were 2 leaks > 5mm (0.8%).
TEE after 6 weeks was performed in 249 patients and the results are presented in Figure 1. 16 patients, who did not undergo follow-up TEE, have not presented any symptoms of device-related thromboembolization.
Device thrombosis after LAA closure with a Watchman device in patients on DAPT is relatively rare and clinically inconsequential. Nevertheless, follow-up TEE should not be neglected as it may reveal the need for pharmacotherapy modification.
STRUCTURAL: Left Atrial Appendage Exclusion