{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T23:40:48Z","timestamp":1767915648495,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T00:00:00Z","timestamp":1715472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left atrial appendage occlusion (LAAO) with WATCHMAN currently requires preprocedural imaging, general anesthesia, and inpatient overnight admission. We sought to facilitate simplification of LAAO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We describe and compare SOLO\u2010CLOSE (single\u2010operator LAA occlusion utilizing conscious sedation TEE, lack of outpatient pre\u2010imaging, and same\u2010day expedited discharge) with the conventional approach (CA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010center retrospective analysis of 163 patients undergoing LAAO between January 2017 and April 2022 was conducted. The SOLO\u2010CLOSE protocol was enacted on December 1, 2020. Before this date,\u00a0we utilized the CA. The primary efficacy endpoint was defined as successful LAAO with \u22645\u2009mm peri\u2010device leak at time of closure. The primary safety endpoint was the composite incidence of all\u2010cause deaths, any cerebrovascular accident (CVA), device embolization, pericardial effusion, or major postprocedure bleeding within 7 days of the index procedure. Procedure times, 7\u2010day readmission rates, and cost analytics were collected as well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were similar in both cohorts. Congestive heart failure (37.5% vs. 11.1%) and malignancy (28.8% vs. 12.5%) were higher in SOLO\u2010CLOSE. Median CHA<jats:sub>2<\/jats:sub>D<jats:sub>2<\/jats:sub>SVASc score was 5 in both cohorts. The primary efficacy endpoint was met 100% in both cohorts. Primary safety endpoint was similar between cohorts (<jats:italic>p<\/jats:italic>\u2009=\u20090.078). Mean procedure time was 30\u2009min shorter in SOLO\u2010CLOSE (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Seven\u2010day readmissions for SOLO\u2010CLOSE was zero. After SOLO\u2010CLOSE implementation, there was a 188% increase in positive contribution margin per case.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The SOLO\u2010CLOSE methodology offers similar efficacy and safety when compared to the CA, while improving clinical efficiency, reducing procedural times, and increasing economic benefit.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31073","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:40:45Z","timestamp":1715564445000},"page":"330-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Single\u2010Operator Left atrial appendage Occlusion utilizing Conscious sedation TEE, Lack of Outpatient pre\u2010imaging, and Same\u2010day Expedited discharge (SOLO\u2010CLOSE): A comparison with conventional approach"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-6525","authenticated-orcid":false,"given":"Hafez","family":"Golzarian","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Internal Medicine Residency Program, Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin A.","family":"Pasley","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Internal Medicine Residency Program, Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6122-3484","authenticated-orcid":false,"given":"Sidra R.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Internal Medicine Residency Program, Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arielle M.","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Structural Heart &amp; Intervention Center, Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mallory","family":"Knous","sequence":"additional","affiliation":[{"name":"Department of Cardiology Structural Heart &amp; Intervention Center, Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna C.","family":"Kleman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Structural Heart &amp; Intervention Center, Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie L.","family":"Saum","sequence":"additional","affiliation":[{"name":"Department of Cardiology Structural Heart &amp; Intervention Center, Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerri L.","family":"Hempfling","sequence":"additional","affiliation":[{"name":"Department of Cardiology Structural Heart &amp; Intervention Center, Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic &amp; Vascular Surgery Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic &amp; Vascular Surgery Bon Secours Mercy Health\u2014St. Rita's Medical Center Lima Ohio 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