Key result
WATCHMAN closure in very small LAA ostia achieves ~97% procedural success with no major complications.
Why the study?
FDA labelling recommends LAA closure with the WATCHMAN device for patients with a maximal LAA ostial width between 17 and 31 mm, leaving the safety and efficacy in patients with an ostial width < 17 mm unevaluated.
Observational (n=32)
Answers are grounded in this paper and cite their sources.
Off-label WATCHMAN use for LAA ostia <17 mm is hypothesis-generating; prospective trials needed before expanding indications.
INTRODUCTION: Left atrial appendage (LAA) closure with the WATCHMAN device, according to FDA labelling, is recommended in patients with a maximal LAA ostial width between 17 and 31 mm. The safety and efficacy of LAA closure in patients with a maximal LAA ostial width < 17 mm has not been evaluated. The goal of this study was to determine the acute and short-term safety and efficacy of LAA closure with the WATCHMAN device in patients with a maximal LAA ostial width < 17 mm. METHODS AND At the screening TEE, mean maximal LAA ostial width and depth were 15.6 ± 0.6 mm (range 14-16) and 23.2 ± 4.5 mm (range 13-31), respectively. Successful LAA closure with the WATCHMAN device was achieved in 31 of 32 patients (97%), with no major complications. TEE performed 45 days after LAA closure demonstrated no peridevice leak > 5 mm and no device related thrombi. Warfarin was discontinued in all 31 patients 45 days after LAA closure. CONCLUSIONS: LAA closure with the WATCHMAN device can be successfully and safely achieved in patients with a maximal LAA ostial width < 17 mm.
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Strickberger et al. (2017) conducted an observational in Patients undergoing left atrial appendage closure with small left atrial appendage ostia (<17 mm) (n=32). Left atrial appendage closure with the WATCHMAN device was evaluated on Successful left atrial appendage closure. LAA closure with the WATCHMAN device in patients with maximal LAA ostial width <17 mm achieved 97% procedural success (31/32) with no major complications or >5 mm leaks at 45 days.
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