First-in-human left atrial appendage closure using the WATCHMAN FLX Pro device: a case report

Area of Science:

• Cardiovascular Interventions
• Medical Device Technology
• Thrombosis Research

Background:

• Device-related thrombosis (DRT) is a complication of left atrial appendage closure (LAAC).
• The WATCHMAN FLX Pro (WFP) features a fluoropolymer-coated membrane to enhance thromboresistance and endothelialization.
• Novel features include radiopaque platinum markers and a 40mm size option.

Observation:

• A 75-year-old patient with atrial fibrillation and bleeding risk underwent first-in-human WFP implantation.
• The procedure was performed successfully under local anesthesia with intracardiac echocardiography guidance.
• Post-procedure, the patient received only daily aspirin, with imaging at 45 days showing optimal device placement and complete LAAC.

Findings:

• Advanced imaging (CT, TEE, MRI) at 45 days indicated successful LAAC with optimal device position.
• A 6mm hypoattenuated thickening was observed, consistent with tissue ingrowth rather than thrombus.
• Radiopaque markers aided deployment, stability assessment, and evaluation of LA protrusion.

Implications:

• The WFP device demonstrates potential for reduced post-procedural antithrombotic regimens.
• Early tissue ingrowth suggests favorable biocompatibility and integration of the device.
• The novel features of the WFP may improve procedural success and long-term outcomes in LAAC.