16-27: Percutaneous Left Atrial Appendage Closure with WATCHMAN device: results from the TRAPS Registry

Abstract

Purpose of the study: The WATCHMAN device for Left Atrial Appendage occlusion (LAAO) has been found effective and non-inferior to the oral anticoagulation (OAC) in patients with atrial fibrillation, and is now adopted in clinical practice. Method used: The TRAPS registry is an observational, multicenter registry involving 4 Italian centers. Patients who underwent LAAO with WATCHMAN device were enrolled, and clinical, demographic and procedural data were collected. Summary of results: In this analysis we included 148 patients. Mean age was 73 + 8 years, 57% of patients were male, 22% had heart failure, 10% had a history of transient ischemic attack, 23% a history of ischemic stroke and 72% a history of bleeding. The baseline CHADS2 score was 2.4 + 1.3, the CHADsVASc score was 3.9 + 2.8 and the HAS-BLED score was 3.3 + 1.1. 57% of the patients were on OAC at the time of implantation. The device was successfully positioned in all patients with no or minimal (, 5mm) leakage, assessed by peri-procedural transesophageal echo. Following intra-procedural complications were reported: 2 pericardial effusions treated with pericardiocentesis, 1 device-associated thrombus formation treated with aspiration, and 1 vascular access dissection. Moreover, device embolization was reported in 1 patient early after the implantation and the device was successfully snared in the iliac bifurcation. The overall rate of adverse events within 7 days was therefore (5/148 = 3.3%). In the present experience, device size was chosen >=20% greater than the LAA diameter in 68% of patients. Comparing the first half with the second half of the study cohort, the procedure duration decreased from 89min to 64min (p , 0.0001). Conclusion: The success rate in LAAO with WATCHMAN was high, and the rate of adverse events was low.We reported an experience-related improvement in procedural duration.