Dados do Trabalho

Título

Initial experience with left atrial appendage occlusion using the Amplatzer™ and the Watchman™ dedicated devices, in a single center from Brazil

Resumo

Background: The Amplatzer™ and the Watchman™ are dedicated devices for percutaneous left atrial appendage (LAA) occlusion. This is an elective procedure planned to avoid thrombus-embolizaton in patients with atrial fibrillation, unable to use anticoagulation.
Objectives: the aim of the study was to describe the initial experience with both devices for percutaneous LAA occlusion.
Methods: This is a single-center study of patients (pts) undergoing percutaneous LAA occlusion. Inclusion criteria considered a formal contraindication for oral anticoagulation, previous history of stroke due to INR lability, left atrial thrombus in use of NOACs, and patient preference. All procedures were done under general anesthesia and transesophageal echocardiography (TEE) guidance. Transthoracic echocardiography was performed during the first 24hs after the procedure in order to rule out complications. Further follow-up was done with clinical visits and TEE.
Results: Between 09-2010 and 12-2023, 40 pts with 76,5 yrs old, 72,5% male, with a mean CHA2DS2-VASC of 4,3 and Has-bled of 2,75 underwent LAA occlusion with the Amplatzer™ device (n24) and the Watchman™ device (n17). Both were successfully implanted in 100% of the pts., without any procedural stroke or device embolization. TEE showed complete LAA sealing in all patients with no residual leaks. Pericardial effusion needing successful pericardiocentesis was observed in 3 patients. During follow-up (range 5-156 months), 1 patient had minor retinal embolization and 5 patients died (1st: cancer; 2nd: not related osteomyelitis; 3rd: chronic renal failure, 4th COVID, 5th pneumonia )
Conclusion: In this initial series of patients, both devices showed a good acute and late performance considering feasibility and safety regarding the successful implantation rate and the low incidence of complications.

Palavras Chave

Structural procedures; Stroke prevention