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Initial Worldwide Experience With the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Atrial Fibrillation

Peter B. Sick, MD^_*,_*, Gerhard Schuler, MD, Karl Eugen Hauptmann, MD, Eberhard Grube, MD, FACC, Steve Yakubov, MD, FACC^||, Zoltan G. Turi, MD, FACC^¶, Gregory Mishkel, MD, FACC^#, Steve Almany, MD, FACC^_** and David R. Holmes, MD, FACC

^_* Krankenhaus der Barmherzigen Brüder, Regensburg, Germany
University of Leipzig, Heart Center GmbH, Leipzig, Germany
Krankenhaus der Barmherzigen Brüder, Trier, Germany
Heart Center Siegburg, Siegburg, Germany
^|| Midwest Cardiology Research Foundation, Riverside Methodist Hospital, Columbus, Ohio
^¶ Cooper Hospital, Camden, New Jersey
^# Prairie Education and Research, Springfield, Illinois
^_** William Beaumont Hospital, Cardiology Center, Royal Oak, Michigan
Mayo Clinic, St. Mary’s Hospital, Rochester, Minnesota.

View larger version (33K): [in this window] [in a new window] [Download PPT slide]   Figure 1 WATCHMAN Implant WATCHMAN device, nitinol cage with a polytetrafluoroethylene membrane on the surface, and fixation barbs around the perimeter

View larger version (66K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Introduction Sheath With Double and Single Curve for Different Anatomical Situations Introducer sheaths with different shapes

View larger version (97K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Six-Month TEE Control With a Well-Positioned WATCHMAN Device in the LAA Little color flow is seen behind the device, and no flow around the margins. LAA = left atrial appendage; TEE = transesophageal echocardiography

View larger version (56K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Layered Thrombus Formation on the Device 6 Months After Implantation LA = left atrial.

View larger version (125K): [in this window] [in a new window] [Download PPT slide]   Figure 5 Anatomical View of the WATCHMAN Device in the LAA in a Patient Who Died From Aortic Dissection This patient died 9 months after implantation. Stable position and endothelialization of the device were confirmed. LAA = left atrial appendage. Reproduced with permission from K. E. Hauptmann, Trier, Germany.

View larger version (29K): [in this window] [in a new window] [Download PPT slide]   Figure 6 Flow Chart of the Trial With Number of Implants and Attempts as Well as Drop Outs Dependent on Generation of Device