B-44 | Outcomes of Left Atrial Appendage Closure With Watchman Device in Cirrhosis

Cirrhosis is a significant source of mortality and morbidity in the USA. Left atrial appendage closure( LAAC) with Watchman device is an alternative strategy to oral anticoagulation for decreasing ischemic stroke risk in selected patients with atrial fibrillation (AF) Outcomes after Watchman device placement in patients with cirrhosis have conflicting results. We queried National Inpatient Sample of the years 2016 to 2020. We identified patients who were admitted for Watchman procedures using ICD10-PCS codes. Risk of mortality and in-hospital complications in cirrhosis group was compared to the non–cirrhosis group using multivariate logistic regression analysis. During 2016-2020, there were a total of 90,060 patients who underwent Watchman device placement in the US of which 1531(1.7%) had cirrhosis while the remaining 88529(98.3%) had absence of cirrhosis. Mean age was 71.7y in cirrhosis vs 76 y in non-cirrhosis group. 630(40.9%) were female in cirrhosis group vs 36954 females (41.8%) in non-cirrhosis group. After adjusting for demographics, there were lower odds of stroke in patients after Watchman device placement (aOR (adjusted odds ratio) 0.226; 95% CI 0.11–0.44 p<0.001) and lower total cost of care in cirrhosis group compared to non–cirrhosis group. There were no differences of in- hospital mortality, GI bleeding, and cardiac tamponade between two groups. (table1) LAAC with Watchman device is associated with lower odds of stroke and lower mean total cost of care in cirrhosis patients .There were no differences of in- hospital mortality, GI bleeding, and cardiac tamponade.