Journal article
Postapproval Community Hospital Experience in the United States with Left Atrial Appendage Closure Device (Watchman)
Journal of stroke and cerebrovascular diseases, v 27(9), pp 2538-2542
Sep 2018
PMID: 29857929
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To review the procedural safety and postimplantation complications of Watchman device implanted at 2 community hospitals for primary prevention of systemic embolization in patients with nonvalvular atrial fibrillation (NVAF) who were not candidates for long-term oral anticoagulation (OAC).
This was a retrospective case series of 48 patients carried out in 2 community hospitals in the United States. Patients with NVAF who had a CHADS2 higher than 2 or CHADS2VASc2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack [TIA] or thromboembolism, vascular disease, age 65-74 years, and female gender) score of 3 or higher and were not candidates for long-term OAC. These patients were selected for implantation of Watchman device. They were followed up at 45 days, 6 months, 9 months, and 12 months after implantation of Watchman device to assess for complications involving the device and to determine if anticoagulation could be discontinued at the 45 days follow-up. They were monitored for any systemic thromboembolism while off anticoagulation.
The success rate of device implantation was 98% (48 of 49). Only a single patient could not get Watchman implantation because of unfavorable left atrial appendage anatomy. Access-related and device implantation-related complications were zero (0%). At 45 days follow-up and end of follow-up duration, the rate of thrombus formation on the Watchman device was 4% (2 of 48). One patient had TIA after warfarin discontinuation.
With improved procedural technique and well-trained operators, Watchman implantation is feasible in a community hospital also.
Metrics
Details
- Title
- Postapproval Community Hospital Experience in the United States with Left Atrial Appendage Closure Device (Watchman)
- Creators
- Koroush Khalighi - Drexel UniversityMunish Sharma - Easton HospitalRohit Masih - Easton HospitalVadim Levin - Easton Hospital
- Publication Details
- Journal of stroke and cerebrovascular diseases, v 27(9), pp 2538-2542
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Web of Science ID
- WOS:000441086000043
- Scopus ID
- 2-s2.0-85047527821
- Other Identifier
- 991019169619504721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Neurosciences
- Peripheral Vascular Disease