Key result
Watchman FLX and LAmbre kissing technique successfully closes a gigantic four-lobed LAA without complications.
Why the study?
Despite growing experience with left atrial appendage closure, anatomical complexities and variations continue to present challenges.
Case Report (n=1)
The kissing technique using Watchman FLX and LAmbre devices is feasible for closing complex, gigantic left atrial appendages with multiple lobes.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for kissing technique in complex giant LAA; prospective studies needed before broader adoption.
Introduction Despite the growing experience with left atrial appendage closure and the variety of closure devices and techniques, challenges remain in some cases due to anatomical complexities and varieties. Methods We report a case of rare and complex LAA anatomy. Cardiac computed tomography and angiography demonstrated a gigantic LAA with four lobes at the level of the ostium that cannot be occluded by the currently approved LAA closure devices in Europe. . Results Watchman FLX (27 mm plug) and LAmbre (16/22 mm lobe/disc) closure devices in the kissing technique were successfully deployed under fluoroscopy and transesophageal echocardiogram guidance without procedure-related complications. Conclusion Watchman FLX (plug) and LAmbre (umbrella and disc) Kissing is feasible. The LAmbre device may close very small or large LAAs with anatomical complexity.
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Elhakim et al. (2026) conducted a case report in Gigantic rare left atrial appendage with four lobes (n=1). Watchman FLX and LAmbre closure devices (kissing technique) was evaluated on Successful deployment and procedure-related complications. Deployment of Watchman FLX and LAmbre closure devices using the kissing technique successfully closed a gigantic four-lobed left atrial appendage without procedure-related complications.
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