AIM To describe our observation on combined left atrial appendage closure (LAAC) procedures using Watchman FLX^TM devices.

METHODS Ninety-four patients underwent LAAC procedures using Watchman FLX^TM devices in the First Affiliated Hospital of Xi’an Jiaotong University from June 2022 to March 2023 were included for this study. The characteristics of demographics, peri-operative and periprocedural complications, adverse events and clinical outcome were described.

RESULTS Compared with the simple LAAO group, the proportion of heart failure in the combined operation group increased (P<0.01), and the proportion of arterial vascular disease increased (P<0.05). There was no significant statistical difference between the two groups in terms of age, gender, body mass index, proportion of hypertension, proportion of diabetes, ejection fraction, creatinine value, CKD stage, dialysis proportion, proportion of hemorrhagic disease history, CHA2DS2-VASc score, HAS-BLED score, LAAO indications and other indicators. The proportion of choosing local anesthesia and using ICE during surgery was higher, and the surgery time and fluoroscopy time were longer in the combined operation group. There was no significant statistical difference in the size and compression ratio of the occluder between the two groups. All occluders were successfully implanted, and there was no cases of occluder replacement. Both groups of patients had no perioperative complications or postoperative instrument related adverse events. In addition, during the follow-up period, there were no clinical adverse events such as major bleeding, ischemic stroke, pericardial effusion, cardiac surgery, or death in both groups.

CONCLUSION Short-term observation of combined procedures using Watchman FLX^TM left atrial appendage occluder shows a good success rate and a low incidence of adverse events.