Size matters - body size and acute device-implantation failure after LAAC

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patient-device mismatch in patients undergoing left atrial appendage closure (LAAC) may lead to failure to implant, dislocation, and cardiac tamponade. There is limited data about patient cohorts that are especially susceptible to these complications. Objective To analyse the association between body height, weight and acute complications due to probable device mismatch. Methods A retrospective analysis from a multicentre registry including consecutive patients undergoing LAAC was performed. Device related complications were defined as dislocation, failure to implant or cardiac tamponade requiring intervention. Results A total of 431 patients from 9 centres were included. Median age was 75 (interquartile range, IQR 70-79) years and 35.7% were female. Mean±SD body height was 171.3±8.8 cm and median weight was 80 (IQR 70-90) kg. Median CHADS-VASc score was 5 (IQR 3-5) and HAS-BLED score was 3 (IQR 3-4). Indications were bleeding (66.6%), stroke (9.7%) and other (23.6%). Acute device-related complications after LAAC occurred in 5.6% of cases (24/431): Failure to implant (3.0%), cardiac tamponade (2.1%), and dislocation (0.7%). Complications occurred significantly more often in the tercile with lowest body weight and highest body height (23.5% vs. 4.3%, p=0.01, Figure). Conclusion Acute device-related complications as sign of patient-device mismatch are most pronounced in patients with lowest body weight and highest body height.