Author + information
- Jiangtao Yu1,
- Lisheng Jiang2,
- Manuela Muenzel1,
- Xin Xue3,
- Zhihua Wang4,
- Adam Fasakas1,
- Thorsten Keil1 and
- Erich Duenninger1
Percutaneous left atrial appendage (LAA) closure is an efficient alternative to oral anticoagulation for the prevention of thromboembolic events in patients with atrial fibrillation. Due to the complexity and variety of LAA anatomy, it may not always be possible to obtain complete closure with a single device. The aim of this study was to evaluate the feasibility and safety of the “kissing-Watchman” technology using double Watchman devices to occlude the LAA with complex anatomy.
In our center, among 319 consecutive patients who underwent LAA closure with the Watchman device from 2012 to Mai 2017, 6 with complex LAA anatomy were implanted double Watchman devices in staged by using kissing-Watchman technology. The anatomic morphology, procedure characteristics, and safety were analyzed.
The anatomic morphology in all 6 patients was cauliflower with at least 2 large lobes. In both procedures, there were no significant differences in X-ray exposure time and dose, but the total procedure time (78.8±25.2 vs. 56.5±18.0 minutes, p=0.11) and contrast volume (182.5±63.9 vs. 121.7±65.2 ml, p=0.13) in the first procedure showed a tendency over the second. All the procedures were successful, without severe complications including device dislocation, thrombosis, pericardial effusion or tamponade, major bleeding and other major adverse events during the 7-day perioperative period.
The staged double “kissing-Watchman” technology is feasible and safe, which might be an efficient strategy to occlude the LAA with complex anatomy when an incomplete closure is inevitable by a single device.
STRUCTURAL: Left Atrial Appendage Exclusion