Introduction: In patients suffering from AFib and exposed to bleeding risks, Left Atrial Appendage Occluders (LAAO) are increasingly being used to prevent thromboembolic complications. During follow up, device dislodgement is routinely excluded by fluoroscopy and transesophageal echocardiography (TEE). We speculated modified transthoracic echocardiographic (TTE) imaging to be potentially sufficiant.
Methods: 53 Patients underwent placement of a LAAO (ACP [n=41], Amulet, [n=12], St,JudeMedical) and were followed by serial TEE, fluoroscopy and transthoracic echocardiography (TTE), using modified apical- and subcostal 4 chamber views with the transducer flexed anteriorly to assess presence and stable location of the occluder.
Results: LAAO size ranged from 16-32mm. All patients underwent TTE- and TTE- imaging using standard Echocardiography machines (General Electrics VividI and Vivid7). Dislodgement was excluded in all pts. Findings were confirmed by TEE and fluoroscopy in all patients and consistent in 43/43 pts. undergoing follow-up TTE.
Conclusions: Echocardiographic non-invasive and non-fluoroscopic confirmation of LAAOs is easily feasable by modified TTE-views, thus avoiding invasive imaging, potentially unnecessary anticoagulation of patients with poor ability to provide history and in any concern about stable occluder position.