Fig. 3
The left atrial appendage closure device (WATCHMAN FLXTM) was placed under fluoroscopy and transoesophageal echocardiography view. After being placed in left atrial appendage, to check its stability and before it is left there, WATCHMAN FLX is subjected to a tension stress (red arrow) (A). Subsequently, with the device still anchored, we documented absence of iodinated contrast media leakage from the sheath (B). At the end of the procedure, after cerebral protection system retraction, a millimetric (3mmx1mm, yellow arrows) thrombus was documented in left carotid basket (C).