Kissing-Watchman technique applied in single-lobulated left atrial appendage anatomy with giant ostia

The only commercially available device in the documented institution is the Watchman (Boston Scientific, Marlborough, MA, USA) occluder which is the predominant occluder in China. The single device approach may not always fit the great anatomic variability of the left atrial appendage (LAA). Adequate closure may require more than a single device. The commercially available Watchman device only fits LAAs with a maximum diameter of 30 mm [1-3]. In patients with bilobulated LAA, the one-stop implantation of double Watchman is feasible as reported by a previous study However, it is unknown whether this approach is feasible in the setting of a single-lobulated LAA with a giant ostium (> 30 mm). Reported herein, is a consecutive case series of patients in whom kissing-Watchman was performed to achieve adequate closure of the single-lobulated LAA with large-ostium.