Page 11 - Journal of Structural Heart Disease Volume 2, Issue 1

5 Review Article
Figure2. PanelA.WATCHMANdevice.TheWATCHMANdeviceconsistsofaself-expandingnitinolframewith xationbarbs.Thereisaporous polyethylene terephthalate membrane on the face of the device which endothelializes over time occluding the ostium of the appendage (image courtesy of Boston Scienti c, Inc.). Panel B. Left atrial appendage (LAA) with pigtail catheter in place. A pigtail catheter is utilized to cannulate the LAA in an atraumatic fashion. Angiography of the LAA is performed to gain an understanding of the anatomy. The WATCH- MAN 14 French sheath is placed over the pigtail into the LAA. Panel C. LAA with WATCHMAN sheath. The pigtail catheter is removed and the WATCHMAN 14 French access sheath is carefully maneuvered distally into the LAA. Marker bands which are visible under uoroscopy allow for determination of where the device will land when access sheath is removed and device unsheathed. Panel D. LAA with WATCHMAN deployed. The device is loaded into the distal sheath and unsheathed with removal of the access sheath while maintaining distal position of the WATCHMAN device within the LAA. The device is secured in position with xation barbs present along the sides of the device which engage the endocardium.
farin was discontinued in those patients who either had complete closure of the LAA or a small peridevice leak (jet < 5 mm in width). After discontinuation of
warfarin, aspirin (81–325 mg) was continued with the addition of plavix (75 mg) until the 6-month follow up. At this point, plavix was discontinued. Aspirin
Sánchez, J.M. et al.
Where Do We Stand Now?