Effects of different compression ratio on efficacy of WATCHMAN left atrial appendage occluders

  AIM  To observe the efficacy and safety of oversized WATCHMAN left atrial appendage (LAA) occluders in patients with non-valvular atrial fibrillation.

  METHODS  Data from patients after implantation of WATCHMAN LAA occluders between October 2016 and October 2019 were analyzed. The patients were divided into oversized group (device compression ratio equal to or greater than 25%) and normal control group. The occurrence of perioperitive and postoperative complications was evaluated.

  RESULTS  A total of 113 patients were included. There were no significant differences in baseline data between the two groups. After a median follow-up period of 14 months (3 to 39 months), there were no complications such as device related thrombosis and cardiac tamponade, no new stroke and peripheral arterial embolism, and no gastrointestinal bleeding, urinary bleeding and intracranial bleeding in oversized group. Compared with those in normal control group, the left atrial appendage bilobal morphology, the exposure shoulder part of occluders and the residual shunt ratio during the postoperative follow-up in oversized group were significantly higher (P <0.05, P <0.01).

  CONCLUSION  The short-to-medium-term follow-up results of oversized WATCHMAN left atrial appendage occluders are safe and effective. However, the incidence of residual shunts after operation is relatively high and the further study should focus on the long-term results in such patients.