Zero-Contrast Versus Contrast-Guided Left Atrial Appendage Occlusion: A Comparative Analysis of Procedural and...

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Contrast injection is standard in left atrial appendage occlusion (LAAO) procedures.
• Advances in imaging and device technology may allow for contrast-free LAAO.
• The contrast-free approach for LAAO is not well-explored.

Purpose of the Study:

• To compare the safety and efficacy of zero-contrast versus contrast-guided LAAO.
• Evaluate procedural success and periprocedural adverse events.
• Assess long-term LAA closure success and clinical outcomes.

Main Methods:

• A registry of 621 patients undergoing LAAO with Watchman FLX™ devices was analyzed.
• Patients were divided into zero-contrast (326) and contrast-guided (295) groups.
• Outcomes including procedural success, adverse events, LAA closure, and device-related thrombus were compared.

Main Results:

• Procedural success was 100% in the zero-contrast group and 99.3% in the contrast-guided group.
• Periprocedural adverse events were similar (1.8% vs. 0.7%).
• LAA closure success at 45 days (99.3% vs. 99.6%) and 1 year (100% vs. 100%) was comparable, with similar rates of device-related thrombus and ischemic events.

Conclusions:

• Zero-contrast LAAO is a safe, effective, and efficient alternative to contrast-guided implantation.
• The procedural and clinical outcomes of zero-contrast LAAO are comparable to those of contrast-guided LAAO.
• This approach may reduce contrast exposure and associated risks.