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Updated: Mar 20, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
The New 3D Printed Left Atrial Appendage Closure with a Novel Holdfast Device: A Pre-Clinical Feasibility Animal
M Brzeziński1, K Bury1, L Dąbrowski2
1Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland.
Insights
A novel 3D-printed left atrial appendage closure device proved safe and effective in swine, achieving full closure without inflammation or thrombi. This technology offers a promising, cost-effective alternative for stroke prevention in high-risk patients.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Medical Device Innovation
Background:
- Patients with atrial fibrillation (AF) often have stroke risk factors.
- Left atrial appendage (LAA) thrombi are a primary source of stroke.
- Anticoagulant therapy carries a high bleeding risk, necessitating alternative treatments.
Purpose of the Study:
- To evaluate the safety and feasibility of a novel left atrial appendage exclusion device.
- To assess a minimally invasive introducer for LAA device placement.
- To test a 3D-printed LAA occlusion device in a swine model.
Main Methods:
- A novel LAA device was designed using finite element modeling and manufactured via selective laser sintering (SLS).
- The device was implanted in 15 swine via minithoracotomy.
- Follow-up periods ranged from 14 days to 6 months, with subsequent explantation and histological analysis.
Main Results:
- Complete LAA closure was achieved in all 15 swine.
- Devices were securely integrated with no signs of inflammation, pericarditis, or thrombi.
- All animals maintained good health throughout the study.
Conclusions:
- The 3D-printed LAA closure device is safe and feasible.
- The device demonstrated effective LAA exclusion with a benign healing response.
- Further clinical studies are warranted to introduce this technology into practice.
Introduction:
Many patients undergoing cardiac surgery have risk factors for both atrial fibrillation (AF) and stroke. The left atrial appendage (LAA) is the primary site for thrombi formation. The most severe complication of emboli derived from LAA is stroke, which is associated with a 12-month mortality rate of 38% and a 12-month recurrence rate of 17%. The most common form of treatment for atrial fibrillation and stroke prevention is the pharmacological therapy with anticoagulants. Nonetheless this form of therapy is associated with high risk of major bleeding. Therefore LAA occlusion devices should be tested for their ability to reduce future cerebral ischemic events in patients with high-risk of haemorrhage.
Aim:
The aim of this study was to evaluate the safety and feasibility of a novel left atrial appendage exclusion device with a minimally invasive introducer in a swine model.
Materials And Methods:
A completely novel LAA device, which is composed of two tubes connected together using a specially created bail, was designed using finite element modelling (FEM) to obtain an optimal support force of 36 N at the closure line. The monolithic form of the occluder was obtained by using additive manufacturing of granular PA2200 powder with the technology of selective laser sintering (SLS). Fifteen swine were included in the feasibility tests, with 10 animals undergoing fourteen days of follow-up and 5 animals undergoing long-term observation of 3 months. For one animal, the follow-up was further prolonged to 6 months. The device was placed via minithoracotomy. After the observation period, all of the animals were euthanized, and their hearts were tested for LAA closure and local inflammatory and tissue response.
Results:
After the defined observation period, all fifteen hearts were explanted. In all cases the full closure of the LAA was achieved. The macroscopic and microscopic evaluation of the explanted hearts showed that all devices were securely integrated in the surrounding tissues. No pericarditis or macroscopic signs of inflammation at the site of the device were found. All pigs were in good condition with normal weight gain and no other clinical symptoms.
Conclusion:
This novel 3D printed left atrial appendage closure technique with a novel holdfast device was proven to be safe and feasible in all pigs. A benign healing process without inflammation and damage to the surrounding structures or evidence of new thrombi formation was observed. Moreover, the uncomplicated survival and full LAA exclusion in all animals demonstrate the efficacy of this novel and relatively cheap device. Further clinical evaluation and implementation studies should be performed to introduce this new technology into clinical practice.
