Seize the day, …s(e)ize the device: the emerging imaging
modality to improve left atrial appendage device sizing
Claudio Tondo, MD, PhD, FESC, FHRS
Heart Rhythm Center at Monzino Cardiac Center, IRCCS, Department of
Biochemical, Surgical and Dentist Sciences, University of Milan, Milan,
Italy.
Correspondence to:
Claudio Tondo, M.D., Ph.D.
Director, Heart Rhythm Center at
Monzino Cardiac Center, IRCCS
Department of Biochemical, Surgical and Dentist Sciences
University of Milan, Milan, Italy
Via Carlo Parea, 4 - 20138 Milan, Italy
Mail: claudio.tondo@ccfm.it;
claudio.tondo@unimi.it
“Funding None”
“Conflict of Interest: None”
In this issue of the Journal, Dallan et al. (1) report their own
experience on the use of a novel computed tomography angiography-based
(CTA) for sizing the Watchman Flex device for left atrial appendage
occlusion (LAAO) . The authors have tested the TruPlan software package
for the methodology and investigated if it can reduce the number of
device deployment and the risk of complications. The principal results
of the study were: 1) A pre-procedural CTA sizing protocol can be
applied successfully with ICE guidance and provide excellent procedural
outcomes; 2) CTA protocol is safe and can provide high success rates
with the WatchmanTM FLX device reducing the number of deployment
attempts and reducing the risk of complications.
Among 136 patients evaluated, pre-procedural CT imaging accurately
predicted the size of the device in 91% of patients. Only in ten
patients a new sized device was required and in 2 patients were aborted.
The authors conclude that the CTA-based pre-procedural sizing
methodology for Watchman Flex occluder is safe, feasible and provide
appropriate device identification with an excellent clinical outcome.