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Updated: Jun 13, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage
Franz Haertel1, Paul Lustermann1, Ali Hamadanchi1
1Department of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany.
Insights
Galectin-3 serum levels can predict the success of left atrial appendage occlusion (LAAO). Persistently high galectin-3 after LAAO indicates residual peri-device leakage, while decreasing levels suggest successful device sealing.
Area of Science:
- Cardiology
- Biomarkers
- Medical Devices
Background:
- Percutaneous left atrial appendage occlusion (LAAO) requires monitoring for residual peri-device leakage (PDL).
- Galectin-3, a protein involved in tissue-foreign body interactions, may indicate PDL and cardiac remodeling post-LAAO.
Purpose of the Study:
- To analyze galectin-3 serum levels in relation to PDL after LAAO.
- To correlate galectin-3 levels with a novel echo-morphological classification of LAAO success.
Main Methods:
- Serum galectin-3 levels were measured in LAAO-eligible patients pre-procedure, at 45 days, and 6 months post-procedure.
- Transesophageal echocardiography assessed LAAO success.
- A new classification (Types A, B, C) categorized LAAO based on device echodensity and thrombotic coverage.
Main Results:
- Galectin-3 levels significantly increased at 45 days post-LAAO, with higher levels in patients with more significant PDL (Type C).
- Successful occlusion (Types A and B) showed decreasing galectin-3 levels by 6 months.
- Persistently elevated galectin-3 at 6 months was observed in patients with relevant PDL (Type C).
Conclusions:
- Elevated galectin-3 serum levels post-LAAO may reflect thrombus formation transitioning to fibrotic scar development.
- A time-restricted decrease in galectin-3 after 6 months correlates with successful LAAO.
- Galectin-3 shows potential as a predictor of LAAO occlusion success and residual PDL.
Abstract:
Echocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage occlusion (LAAO) is crucial for managing anticoagulation. Galectin-3, a protein involved in tissue-foreign body interactions, may hold significance in understanding PDL and cardiac tissue remodeling after LAAO. This study aimed to analyze galectin-3 serum levels in relation to PDL using a novel echo-morphological classification. LAAO eligible patients were included in the study. Galectin-3 serum levels were measured before LAAO, at 45 days (45D), and at 6 months (6M) after the procedure. Transesophageal echocardiography was used to assess LAAO success. A new echo-morphological classification categorized the degree of LAAO into three different types (A: homogenous echodensity, indicating completely thrombosed device; B: inhomogeneous echolucencies (<50% of device); and C: partially thrombosed device with echolucencies > 50%). Among 47 patients, complete LAAO was achieved in 60% after 45D and in 74% after 6M. We observed a significant increase and distribution of serum levels of galectin-3 [ng/mL] after 45D among the three types (baseline: 13.1 ± 5.8 ng/mL; 45D: 16.3 ± 7.2 ng/mL (Type A) vs. 19.2 ± 8.6 ng/mL (Type B) vs. 25.8 ± 9.4 ng/mL (Type C); p = 0.031), followed by a drop in galectin-3 for Types A and B after 6M toward and below the baseline levels (6M: 8.9 ± 3.1 ng/mL (Type A) vs. 12.4 ± 5.5 ng/mL (Type B)), whereas Type C persisted in showing elevated galectin-3 levels compared to all other types (6M: 17.5 ± 4.5 ng/mL (Type C); p < 0.01). Increased galectin-3 serum levels after LAAO likely reflect the transition from thrombus formation to fibrotic scar development in the LAA lumen. Successful occlusion is associated with a time-restricted decrease in galectin-3 levels after 6 months, while relevant PDL leads to persistently elevated levels, making galectin-3 a potential predictor of occlusion success.
