16 May 2024
LAA closure - LIVE case
LAA closure cases on general or local anesthesia
Summary
A 78-year-old woman with hypertension, diabetes, obesity, and a history of pacemaker implantation in 2023, presented with retinal hemorrhage while on NACO for AF. Despite a CHA2DS2-VASC score of 5, anticoagulation was withdrawn. The operators implanted a Watchman device in the LAA via a venous right femoral approach under TEE and general anaesthesia.
Additionally, watch 2 recorded cases with the Amulet device on local anaesthesia (one guided by ICE, the other guided by microTEE).
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LIVE Educational Case from Netcare Sunninghill Hospital, Johannesburg - South Africa
Key moments
- 20:23-22:00 - Venous femoral puncture under echo
- 25:45-31:36 - Trans septal puncture
- 41:40-54:19 - Step-by-step watchman deployment
- 01:15:45-01:28:44 - Case guided by ICE
- 01:21:15-01:25:32 - Case guided by microTEE
Keywords: Venous echo puncture, LAA closure, Watchman, Amulet, ICE, microTEE, venous proglide closure
Learning Objectives
- To learn how to perform an optimal and safe trans-septal puncture
- To learn how to perform a step-by-step LAA closure procedure
- To understand how to assess the closure result and determine safety of device release
