Rapid and Affordable 3-Dimensional Prototyping for Left Atrial Appendage Closure Planning
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An 82-year-old male with the past medical history of right-sided cerebrovascular accident with mild residual deficits, paroxysmal atrial fibrillation, and recurrent gastrointestinal bleeds while on oral anticoagulation was referred for transcatheter left atrial appendage (LAA) closure using the commercially available Watchman closure device (Boston Scientific, Natick, MA).
Prescreening transesophageal echocardiogram images were obtained to assess the LAA size and morphology. The initial transesophageal echocardiogram images revealed a cauliflower configuration of the LAA with an os measurement of 18 mm (Figure 1A through 1C). A proximal posteriorly directed pocket was noted on imaging. Given that this pocket could act as the landing zone for the device, it may lead to inadequate depth and inadequate LAA coverage.