Results
Patient characteristics are listed in Table 1. All patients had
a strong indication for stroke prophylaxis with an average
CHA2DS2-VASc score 5.4 (range 3-8), and
4 patients had a history of prior bleeding complications while on
anticoagulation (2 with prior intracranial hemorrhage, 2 with prior
gastrointestinal bleeding requiring transfusions). Four patients had
previously undergone surgical LAA ligation with an average time between
surgical and endovascular LAA closure of 6.4 ± 3.6 years. Of these four
patients, three had anticoagulation stopped after the surgical LAA
ligation. Of these three patients, one had a subsequent TEE as part of a
cardioversion and was found to have the residual connection and a
thrombus in the LAA. Another experienced a thromboembolic event. The
fifth patient had a previous WATCHMAN device placed but had a persistent
communication of the LAA to the LA. Of the five patients, three
presented to the percutaneous closure procedure on uninterrupted
therapeutic anticoagulation; the other 2 were on ASA monotherapy
(Table 2 ).