Utilization of WATCHMAN FLX for surgically incomplete left atrial appendage occlusion: a multicentre case series.

Content Provider	Europe PMC
Author	Golzarian, Hafez Mariam, Alaha Shah, Sidra R Pasley, Benjamin A Ansah, Kofi N Verma, Anil Mehzad, Reza Patel, Sandeep M
Editor	Montalto, Claudio Rroku, Andi Sohal, Sumit Athithan, Lavanya Waight, Michael
Copyright Year	2023
Abstract	BackgroundIn patients with non-valvular atrial fibrillation, the vast majority of thrombi originate in the left atrial appendage (LAA). Thus, occluding the LAA significantly reduces one’s risk for developing an ischaemic stroke. To date, many different surgical methodologies in LAA occlusion (LAAO)/exclusion have been studied and utilized. Unfortunately, patients are often left with incomplete closure of their LAA, leaving behind residual lobes that continue to allow thrombus formations. With the recent rise in percutaneous approaches and devices such as the WATCHMAN FLX, there have been proven success rates in achieving total closure of the LAA. Reports and investigations regarding the utilization of WATCHMAN FLX devices in patients with surgically incomplete LAAO remain limited.Case summaryWe present three cases of patients who had previously undergone surgical exclusion of the LAA yet unfortunately were left with residual LAA that continued to place them at high risk for an ischaemic stroke. Percutaneous LAAO with the WATCHMAN FLX was utilized to successfully achieve complete sealing of the residual lobes in failed LAA surgical closures.DiscussionOur multicentre case series elucidates that an increased risk of stroke due to surgical LAAO failure is a real-world possibility that is likely to be encountered in clinical practice. We demonstrate in this series how the WATCHMAN FLX may provide a feasible and safe method to supplement a surgically incomplete LAAO to allow for improved ischaemic stroke and systemic embolization risk reduction.
Page Count	8
Journal	European Heart Journal: Case Reports
Volume Number	7
PubMed Central reference number	PMC10118629
Issue Number	4
PubMed reference number	37090745
e-ISSN	25142119
DOI	10.1093/ehjcr/ytad160
Language	English
Publisher	Oxford University Press
Publisher Date	2023-04-05
Publisher Place	US
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.
Subject Keyword	WATCHMAN Atrial fibrillation Left atrial appendage Closure device Percutaneous intervention Stroke prophylaxis TTE ICE Case series
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine