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Failure of Complete Endothelialization of a Watchman Device 3 Years Post-Implantation.

ABSTRACT: We report an unusual case of incomplete endothelialization of the Watchman device >3 years after its implantation. Animal data suggest that device endothelialization occurs ∼45 days post-implantation; however, data on humans are lacking. Guidelines on anticoagulation are based on expectation from animal studies. (Level of Difficulty: Advanced.).

SUBMITTER: Batnyam U

PROVIDER: S-EPMC8310938 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Failure of Complete Endothelialization of a Watchman Device 3 Years Post-Implantation.

Batnyam Uyanga U Tuluca Alexandra A Witzke Christian F CF Greenspan Allan M AM Mainigi Sumeet K SK

JACC. Case reports 20201111 2

We report an unusual case of incomplete endothelialization of the Watchman device >3 years after its implantation. Animal data suggest that device endothelialization occurs ∼45 days post-implantation; however, data on humans are lacking. Guidelines on anticoagulation are based on expectation from animal studies. (<b>Level of Difficulty: Advanced.</b>). ...[more]

PMID: 34317527

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Cardiac computed tomography following Watchman FLX implantation: device-related thrombus or device healing?

Project description:AimsCardiac computed tomography (CT) is increasingly utilized during follow-up after left atrial appendage closure (LAAC). Hypoattenuated thickening (HAT) is a common finding and might represent either benign device healing or device-related thrombosis (DRT). The appearance and characteristics of HAT associated with the Watchman FLX have not been previously described. Therefore, we sought to investigate cardiac CT findings during follow-up after Watchman FLX implantation with a focus on HAT and DRT.Methods and resultsRetrospective single-centre, observational study including all patients with successful Watchman FLX implantation and follow-up cardiac CT between March 2019 and September 2021 (n = 244). Blinded analysis of CT images was performed describing the localization, extent, and morphology of HAT and correlated to imaging and histology findings in a canine model. Relevant clinical and preclinical ethical approvals were obtained.Overall, HAT was present in 156 cases (64%) and could be classified as either subfabric hypoattenuation (n = 59), flat sessile HAT (n = 78), protruding sessile HAT (n = 16), or pedunculated HAT (n = 3). All cases of pedunculated HAT and five cases of protruding sessile HAT were considered as high-grade HAT (n = 7). Subfabric hypoattenuation and flat sessile HAT correlated with device healing and endothelialization in histological analysis of explanted devices.ConclusionSubfabric hypoattenuation and flat sessile HAT are frequent CT findings for Watchman FLX, likely representing benign device healing and endothelialization. Pedunculated HAT and protruding HAT are infrequent CT findings that might represent DRT.

| S-EPMC9867931 | biostudies-literature

Comparative Endothelialization of the Watchman Plug Device and LACBES Pacifier Occluder after Left Atrial Appendage Closure