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Updated: Jul 12, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
State-of-the-Art of Transcatheter Left Atrial Appendage Occlusion
Luigi Emilio Pastormerlo1, Alberto Ranieri De Caterina1, Augusto Esposito1
1UOC Diagnostica Interventistica Fondazione Toscana Gabriele Monasterio Massa, 54100 Massa, Italy.
Insights
Left atrial appendage occlusion (LAAO) offers an alternative to blood thinners for atrial fibrillation patients. This review details patient selection, device options, and imaging techniques for safe and effective LAAO procedures.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Atrial fibrillation necessitates stroke prevention, often with oral anticoagulation.
- Oral anticoagulation carries bleeding risks, limiting its use in some patients.
- Left atrial appendage occlusion (LAAO) is an alternative therapy for specific patient groups.
Purpose of the Study:
- To review patient selection criteria for LAAO.
- To provide an overview of currently available LAAO devices.
- To discuss the role of imaging in LAAO procedures.
Main Methods:
- Literature review focusing on patient selection for LAAO.
- Comparative analysis of different LAAO devices.
- Examination of imaging modalities for LAAO planning, guidance, and follow-up.
Main Results:
- Key indications for LAAO include high bleeding risk, gastrointestinal bleeding history, and end-stage renal disease.
- Various LAAO devices exist, each with distinct features and potential advantages.
- Imaging is crucial for optimizing procedural safety, efficacy, and patient outcomes.
Conclusions:
- LAAO is a viable alternative for selected atrial fibrillation patients.
- Device selection should consider patient-specific factors.
- Comprehensive imaging strategies enhance LAAO success rates.
Abstract:
Left atrial appendage occlusion (LAAO) is an increasingly used alternative to oral anticoagulation in patients with atrial fibrillation, especially in patients with absolute/relative contraindications to these therapies. This review will cover three main aspects of the procedure. In the fist part of the manuscript, we focus on patient selection. We describe three main categories of patients with primary indication to LAAO, namely patients with previous or at a high risk of intracerebral bleeding, patients with a history of major gastrointestinal bleeding and patients with end-stage renal disease and absolute contraindication to novel oral anticoagulants. Some other potential indications are also described. In the second part of the manuscript, we review available devices, trying to highlight different aspects and potential specific advantages. The last section overviews different ways for pre-, intra- and postprocedural imaging, in order to improve procedural safety and efficacy and ameliorate patient outcome. The characteristics of available contemporary devices and the role of imaging in procedural planning, intraprocedural guidance and follow-up are described.
