Periprocedural complications
thrombosis, cognitive impairment, stroke, worsened limb hemiplegia, dislocation, peri-device leakages, ischemic stroke, cardiac tamponade, thrombus, Pericardial tamponade, hemiplegia, cerebral infarction, Pericardial effusion
THROMBOSIS, STROKE, EVENT, ISCHEMIC STROKE, CARDIAC TAMPONADE, THROMBUS, PERICARDIAL TAMPONADE, EVENTS, CEREBRAL INFARCTION, PERICARDIAL EFFUSION
Of the 673 patients who underwent LAAC in our study. the implantation attempts were aborted in 11 patients due to unfavorable LAA anatomy (determined by in-procedural angiography). 3 implantation operations were considered unsuccessful due to major peri-device leakages(> 5 mm). Other failure reasons included one device dislocation (the device was successfully snared but re-implantation was not attempted) and one cardiac tamponade requiring surgical intervention and LAA ligation. Ultimately, the successful rate was 97.62% (657 of 673). Of these, 533 (80.76%) were implanted with Watchman devices, 62 (9.38%) were implanted with Lambre devices, 52 (7.88%) were implanted with ACP devices, 12 were implanted with devices of other brands and 1 with Lefort device (Table Procedural detailsTEE: trans-esophageal echocardiography; ACP: Amplatzer Cardia PlugThe rate of peri-operative adverse events was 1.19% (8 of 673). Pericardial tamponade occurred in 3 patients (one patient had surgical LAA ligation, the other 2 underwent percutaneous pericardial drainage). Peri-procedural cerebral infarction was recorded in 2 patients. One received non-interventional medical treatment and fully recovered. Another one had hemiplegia and suffered from a second stroke 2 months after LAAC, which caused cognitive impairment and worsened limb hemiplegia. Device dislocation occurred in 2 patients. One was successful snared but re-implantation was not attempted. The patient had repeated ischemic stroke attacks (three times) during the long-term follow-up, leaving cognitive impairment and limb hemiplegia. For the other patient, the dislocated LAAC device was successfully snared and a new device was implanted. He completed the follow-up without any events.Device-related thrombus (DRT) occurred in 1 patient (0.15%). The patient was put on anticoagulation treatment and no cerebrovascular event occurred during the peri-procedure period. However, the thrombosis on the device did not disappear at the 45 days TEE follow-up. Despite of the long-term anticoagulation treatment, the patient had fatal ischemic stroke 4 years after LAAC despite of continued anticoagulation. Pericardial effusion of more than 10 mm occurred in 10 patients (1.49%) all of which had no symptoms and absorbed simultaneously.