CTICasesWatchman Left Atrial Appendage Occlusion Device with Normal Post-Procedural Porosity
Imaging findings
Early arterial phase gated CT demonstrates the Watchman left atrial appendage occlusion device well-seated within the left atrial appendage, without evidence of clot on the atrial side of the device. Delayed phase CT, performed approximately thirty days after placement, reveals contrast opacification and enhancement within the distal portion of the left atrial appendage behind the device.
Key takeaways
The Watchman is an implantable left atrial appendage occlusion device designed to reduce thromboembolic stroke risk in patients with non-valvular atrial fibrillation. In the early post-procedural period (e.g., thirty days), delayed-phase contrast enhancement within the distal appendage is observed in a high percentage of patients (up to fifty percent), representing normal ongoing device porosity rather than device malfunction, which typically still prevents macro-thrombi from embolizing.
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