{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:40:55Z","timestamp":1747147255171,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To propose a novel method for mapping leak location and frequency to a clock\u2010face representation of the left atrial appendage (LAA) ostium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>LAA occlusion with the Watchman device (WD) is an established therapy to reduce thromboembolic events in patients with atrial fibrillation (AF) and intolerance to long\u2010term oral anticoagulation. Postimplantation leaks are known sequelae, but leak locations and characteristics are poorly described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed 101 consecutive WD implants from April 2015 to February 2018. Leak locations from 6\u2010week post\u2010implant transesophageal echocardiograms were mapped to a clock\u2010face representation of the LAA ostium: 12:00 as cranial near the limbus, 3:00 as anterior toward the pulmonary artery, 6:00 as caudal near the mitral annulus, and 9:00 as posterior. Patient demographics, LAA dimensions, and procedural characteristics were also collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four patients had \u22651 leak totaling 45 leaks at 6\u2010week follow\u2010up. Baseline patient demographics showed a mean age 77, CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>VASc 4.69, and 64% of patients with permanent AF. No patient had a detectable leak at the time of implant. At 6\u2009weeks, mean leak size was 2.67\u2009\u00b1\u20090.89\u2009mm with no leak over 5\u2009mm (largest 4.60\u2009mm). Most leaks occurred along the posterior 6:00\u201312:00 segment (39\/45) and the 6:00\u20139:00 quadrant (16\/45).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Six\u2010week post\u2010WD implant leaks localize to the posterior LAA ostium. This could result from the elliptical LAA orifice, differential LAA tissue composition, or implantation technique. This study provides a novel method for describing the location of post\u2010implant leaks and serves as the basis for further investigations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28796","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T12:32:35Z","timestamp":1582201955000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A novel clock\u2010face method for characterizing peridevice leaks after left atrial appendage occlusion"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7187-2445","authenticated-orcid":false,"given":"Sarah K.","family":"Westcott","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Medical Center  Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-2145","authenticated-orcid":false,"given":"William","family":"Wung","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Medical Center  Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5282-0973","authenticated-orcid":false,"given":"Matthew","family":"Glassy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Medical Center  Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9123-8038","authenticated-orcid":false,"given":"Gagan D.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of California Davis Medical Center  Sacramento 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