{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T04:12:01Z","timestamp":1741839121072,"version":"3.38.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"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":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While studies have shown the advantages of computed tomography angiography (CTA) over transesophageal echocardiography (TEE) in left atrial appendage closure (LAAC) preprocedural planning for WATCHMAN\u2122\u00a0legacy and FLX devices, there has been no reported long\u2010term data for this approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to evaluate long\u2010term outcomes using CTA\u2010based preprocedural planning for LAAC using the WATCHMAN\u2122 device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective analysis of 231 consecutive patients who underwent LAAC in a single, large academic hospital in the United States was conducted over a 5\u2010year period. CTA\u2010guided preprocedural planning was performed in all. Procedural success, adverse events, length of procedure, number of devices used, and length of stay were evaluated. Rates of death, cerebral embolism, systemic embolism, and major and minor bleeding were recorded. Adjusted predicted stroke and major bleeding rates were derived from CHA2DS2\u2010Vasc and HAS\u2010BLED scores, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From January 26, 2017, to November 23, 2021, 231 patients underwent LAAC with CTA preprocedural planning by two operating physicians. The mean age of patients was 76.5\u2009\u00b1\u20098.4. 59.7% of patients were male. Mean CHA2DS2VASc and HAS\u2010BLED scores were 4.5\u2009\u00b1\u20091.4 and 3.9\u2009\u00b1\u20090.9, respectively. All procedures were performed with intracardiac echo (100%). The procedural success rate was 99.1%. The CTA sizing strategy accurately predicted the implant size in 93.5% of patients. Mean number of devices used was 1.10\u2009\u00b1\u20090.3. Peri\u2010procedural complication rate was 2.2%. 6 patients were lost to follow\u2010up. Mean follow\u2010up was 608.94 days with a total of 377.04 patient years. Median follow\u2010up period of 368 days (interquartile range: 209\u20131067 days). There were 51 deaths from all causes (13.52 per 100 patient\u2010years), 10 cases of cerebral embolism (2.65 per 100 patient\u2010years), 2 cases of systemic embolism (0.53 per 100 patient\u2010years), 17 cases of major bleeding (4.50 per 100 patient\u2010years), and 31 cases of minor bleeding (8.2 per 100 patient\u2010years). All\u2010cause mortality at 1, 2, and 3 years was 12.7%, 20.9%, and 29.2%, respectively. CV event rates at 1, 2, and 3 years were 2.1%, 6.6%, and 10.5%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CTA\u2010based\u00a0preprocedural planning is accurate in predicting device size for LAAC and associated with excellent clinical outcomes at 5 years.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30843","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T08:40:40Z","timestamp":1696322440000},"page":"129-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Midterm follow\u2010up after computed tomography angiography planned left atrial appendage closure"],"prefix":"10.1002","volume":"103","author":[{"given":"Mohammad Atif","family":"Rana","sequence":"first","affiliation":[{"name":"Division of Cardiology Harrington Heart &amp; Vascular Institute, University Hospitals Cleveland Medical Center Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunghan","family":"Yoon","sequence":"additional","affiliation":[{"name":"Division of Cardiology Harrington Heart &amp; Vascular Institute, University Hospitals Cleveland Medical Center Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Augusto Palma","family":"Dallan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Harrington Heart &amp; Vascular Institute, University Hospitals Cleveland Medical Center Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour","family":"Tashtish","sequence":"additional","affiliation":[{"name":"Division of Cardiology Harrington Heart &amp; Vascular Institute, University Hospitals Cleveland Medical Center Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-1242","authenticated-orcid":false,"given":"Guilherme 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