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Updated: Feb 15, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Residual echocardiographic and computed tomography findings after thoracoscopic occlusion of the left atrial
Pavel Osmancik1, Petr Budera2, Jana Zdarska1
1Cardiology Clinic, Third Department of Internal Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic.
Insights
Thoracoscopic left atrial appendage (LAA) occlusion is safe and effective for atrial fibrillation (AF) treatment. Echocardiography reveals small residual pouches post-procedure, indicating successful occlusion.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Imaging
Background:
- Thoracoscopic occlusion of the left atrial appendage (LAA) is a standard procedure for atrial fibrillation (AF) treatment.
- Evaluation of residual findings after LAA occlusion using echocardiography has not been previously described.
Purpose of the Study:
- To describe the residual findings of thoracoscopically occluded LAA using echocardiography.
- To assess the efficacy and safety of LAA occlusion in patients undergoing hybrid ablation for AF.
Main Methods:
- Forty patients with AF undergoing hybrid ablation were enrolled.
- Transesophageal echocardiography was performed post-procedure (2-5 days and 2-3 months) to measure residual LAA pouches.
- Computed tomography was used to measure residual pouch volume and device placement relative to the circumflex artery.
Main Results:
- The LAA occlusion success rate was 97.5% at 2-5 days post-surgery.
- No reperfused LAA were observed; only residual stumps were present.
- Mean stump depth was 12.9 mm, area 2.2 cm², and volume 3.6 ml.
Conclusions:
- LAA occlusion with the AtriClip PRO device is a safe and effective procedure for AF treatment.
- The procedure is associated with the presence of small residual pouches, confirmed by echocardiography.
- Echocardiography is a valuable tool for evaluating residual findings after LAA occlusion.
Objectives:
Thoracoscopic occlusion of the left atrial appendage (LAA) has become a routine part of thoracoscopic ablation for the treatment of atrial fibrillation (AF). Evaluation of residual findings of the occluded LAA by echocardiography has yet to be described.
Methods:
Patients with AF indicated for hybrid ablation (thoracoscopic procedure followed by catheter ablation) were enrolled in this study. LAA was occluded as a routine part of the thoracoscopic procedure. Follow-up transoesophageal echocardiography was performed at the end of the procedure, 2-5 days and 2-3 months after the procedure (before the endocardial stage). The residual pouches of the LAA were measured in the mitral valve view (30-110°) and in the perpendicular view. The depth of the residual pouch was measured from the ostial plane (connecting the Coumadin ridge and the circumflex artery) to the deepest part of the residuum. The volume of the residual pouch and the distance from the circumflex artery to the proximal and the distal ends of the AtriClip were measured using computed tomography.
Results:
Forty patients were enrolled in this study. The success rate for the occlusion of the LAA, assessed on transoesophageal echocardiography 2-5 days after surgery, was 97.5%. Regarding the residual findings, no reperfused LAAs were found, and only residual stumps remained. The depth of the stump was 12.9 ± 5.9 mm, the area was 2.2 ± 1.1 cm2, and the volume was 3.6 ± 1.9 ml (all data are shown as mean ± standard deviation).
Conclusions:
The occlusion of the LAA using an AtriClip PRO device was a clinically safe procedure with high efficacy and was associated with the presence of a small residual pouch after occlusion.
Clinical Trial Registration:
NCT02832206.
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