B-PO03-153 LEFT ATRIAL APPENDAGE OCCLUSION IN PATIENTS WITH PERSISTENT THROMBUS: A CASE SERIES

Abstract

Percutaneous left atrial appendage (LAA) closure is contraindicated in patients with persistent LAA thrombus. This leaves a small number of patients at very high risk of future stroke. There are no established alternatives to treat these patients. Evaluate novel approaches to perform LAA closure in patients with persistent LAA thrombus. A retrospective review of Watchman™ implants performed at our institution to identify patients who were implanted with persistent LAA thrombus. Three patients underwent implantation of the Watchman device despite persistent LAA thrombus. The first patient had a Watchman 2.5 device and the other two underwent a Watchman flex device implant. All implants were performed with concurrent use of the Sentinel cerebral protection system (CPS). There were no periprocedural cerebrovascular events and all three patients were implanted successfully. Follow-up imaging at a 6-week interval showed a well-seated device and no evidence of device related thrombus or peri-device leaks. In patients with persistent LAA thrombus, implantation of the Watchman device appears to be safe and effective when performed with concurrent use of Sentinel cerebral protection system (CPS). A larger retrospective registry and further prospective data are needed to confirm these findings.