Impact of Angiographically Detected Residual Trabeculation After Left Atrial Appendage Closure Using the WATCHMAN Device: Insight From the OCEAN-LAAC Registry.

• Tác giả: Masahiko Asami, Ryuki Chatani, Daisuke Hachinohe, Kentaro Hayashida, Masaki Izumo, Kazushige Kadota, Shunsuke Kubo, Takeshi Maruo, Shingo Mizuno, Kazuki Mizutani, Kazunori Mushiake, Toru Naganuma, Masaki Nakashima, Naoki Nishiura, Yohei Ohno, Hideharu Okamatsu, Sachiyo Ono, Mitsuru Sago, Mike Saji, Shinichi Shirai, Shuhei Tanaka, Tomoyuki Tani, Hiroshi Ueno, Yusuke Watanabe, Masanori Yamamoto
• Ngôn ngữ: eng
• Ký hiệu phân loại: 612.665 Climacteric
• Thông tin xuất bản: United States : Journal of cardiovascular electrophysiology , 2025
• Bộ sưu tập: NCBI
• ID: 188624

Tóm tắt

 BACKGROUND: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited. OBJECTIVES: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device. METHODS: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry. The inclusion criteria comprised patients who successfully underwent LAAC and whose presence or absence of residual trabeculation can be confirmed using a contrast medium. The clinical outcomes were compared between patients with and without angiographically detected residual trabeculation. RESULTS: Residual trabeculation was angiographically detected in 5.6% (75/1350 patients). At the procedure, the proportion of peri-device leak (PDL) was significantly higher in the residual trabeculation group than in the non-residual trabeculation group (20% vs. 5.1%, p <
  0.001). However, the PDL and device-related thrombosis at 45 days and 1 year were comparable between the two groups (37% vs. 23%, p = 0.24
  28% vs. 31%, p = 0.84
  2.1% vs. 1.4%, p = 0.50
  6.9% vs. 6.0%, p = 0.69, respectively). The 3-year cumulative incidence of ischemic stroke, all cardiovascular death, and all-cause death were comparable between the two groups (5.7% vs. 5.5%, log-rank p = 0.96
  7.7% vs. 8.9%, log-rank p = 0.34, 31.4% vs. 22.3%, log-rank p = 0.71, respectively). CONCLUSION: The angiographically detected residual trabeculation rate was 5.6%, and this population had a significantly higher prevalence of PDL at the procedure. However, the presence of residual trabeculation did not contribute to PDL or device-related thrombosis at follow-up or affect the clinical outcomes.