Author + information
- Nidhi Madan,
- Mark Kosinski,
- Konstantinos Voudris,
- Nusrat Jahan,
- Luke R. McCormack,
- Henry Huang and
- Clifford Kavinsky
Percutaneous left atrial appendage (LAA) closure is increasingly used to reduce risk of stroke in select patients with Afib. Typically, preprocedural imaging (TEE or cardiac CT) is performed for device selection. This results in multiple procedures, increased risks, patient disengagement. We postulated that LAA occlusion (Watchman device) can be effectively accomplished using intraprocedural TEE and fluoroscopy, without preprocedural imaging.
20 consecutive patients who underwent Watchman device placement without preprocedural imaging from Feb 2018 to Sept 2019 at Rush University Medical Center were included. Outcomes: procedural success; complications (groin hematoma, tamponade, MI, stroke, death); device position, peridevice leak postprocedure and on 45 day TEE.
Mean age 74.2 yrs, 50% females, 60% Whites (Table1). Watchman device was successfully implanted in all patients. LAA ostium by both intraprocedural TEE and angiography strongly correlated with device size (Pearson's r for angiography= 0.84, p<0.0001; r for TEE = 0.69, p=0.0007). Angiography predicted device size more effectively than TEE (R2=0.71 vs. R2=0.48 respectively). 12 of 20 patients completed TEE at 45 days, all showed good device position and no significant peridevice leak.
LAA occlusion with Watchman device can be safely performed using intraprocedural TEE and fluoroscopy. Our study is first to suggest that preprocedural imaging may not be necessary in these patients.
Posters Hall_Hall A
Saturday, March 28, 2020, 12:30 p.m.-1:15 p.m.
Session Title: Interventional Cardiology: Mitral and Structural Heart Disease 2
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1152-028
- 2020 American College of Cardiology Foundation