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Updated: Nov 12, 2025
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Leaks after Left Atrial Appendage Closure: Ignored or Neglected?
Sun-Joo Jang1, S Chiu Wong2, Bobak Mosadegh3
1Dalio Institute of Cardiovascular Imaging, New York Presbyterian Hospital and Weill Cornell Medicine, New York, New York, USA.
Cardiology
|March 18, 2021
Summary
Left atrial appendage (LAA) closure prevents strokes in atrial fibrillation patients. Incomplete closure can cause leaks, but their link to blood clots needs more research.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis Prevention
Background:
- Left atrial appendage (LAA) closure is an alternative stroke prevention method for atrial fibrillation patients unable to use oral anticoagulation.
- Incomplete LAA closure, due to device design and anatomical variations, can result in peri-device leaks (PDLs).
Purpose of the Study:
- To review the clinical significance of PDLs after LAA closure procedures.
- To discuss the association between PDLs and thromboembolic events.
- To highlight challenges in managing severe leaks and the need for further research.
Main Methods:
- Literature review of studies on LAA closure and PDLs.
- Analysis of current evidence regarding PDL size and thromboembolic risk.
- Discussion of management strategies for PDLs.
Main Results:
- Residual leaks (PDLs) are common after LAA closure, irrespective of the method used.
- PDLs <5 mm have not been definitively linked to increased thromboembolic risk.
- Leaks after epicardial LAA closure correlate with increased thromboembolism risk.
Conclusions:
- The clinical significance of PDLs, especially smaller ones, remains controversial and requires further investigation.
- Management of severe PDLs is challenging.
- Large, long-term studies are needed to clarify the role of PDLs in predicting thromboembolic events and to establish optimal management strategies.
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