Watchman FLX Implantation for Challenging Left Atrial Appendage Anatomy: Case-Based Discussion

Abdulaziz Joury; Joseph A R Englert 3rd; Michael Bernard; James S Jenkins; Homeyar Dinshaw; Yvonne Gilliland; Salima Qamruddin

doi:10.1016/j.cpcardiol.2022.101266

Watchman FLX Implantation for Challenging Left Atrial Appendage Anatomy: Case-Based Discussion

Curr Probl Cardiol. 2022 Sep;47(9):101266. doi: 10.1016/j.cpcardiol.2022.101266. Epub 2022 May 27.

Authors

Abdulaziz Joury¹, Joseph A R Englert 3rd², Michael Bernard², James S Jenkins², Homeyar Dinshaw³, Yvonne Gilliland², Salima Qamruddin⁴

Affiliations

¹ Department of Cardiology, Ochsner Medical Center, New Orleans, LA; King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia.
² Department of Cardiology, Ochsner Medical Center, New Orleans, LA; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
³ The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
⁴ Department of Cardiology, Ochsner Medical Center, New Orleans, LA; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA. Electronic address: salima.qamruddin@ochsner.org.

PMID: 35644503
DOI: 10.1016/j.cpcardiol.2022.101266

Abstract

Left atrial appendage (LAA) occlusion devices provided an acceptable and valid alternative to anticoagulation among patients with atrial fibrillation who carry high bleeding risk. Watchman device is non-inferior to oral anticoagulation to prevent cerebrovascular accidents. The presence of a longer distal portion of the older generation Watchman led to exclusion of patients with prohibitive anatomy of the LAA such as chicken-wing morphology or shallow LAA. Watchman FLX provides a wider range of sizes and can be implanted with complex anatomy or shallow LAA. In the case series, we discuss 3 patients with challenging LAA anatomy that underwent successful Watchman FLX implantation.

Publication types

Review

MeSH terms

Anticoagulants
Atrial Appendage* / diagnostic imaging
Atrial Appendage* / surgery
Atrial Fibrillation* / complications
Atrial Fibrillation* / surgery
Cardiac Catheterization
Humans
Prosthesis Design
Stroke* / etiology
Stroke* / prevention & control
Treatment Outcome

Substances

Anticoagulants