{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:38:25Z","timestamp":1776724705255,"version":"3.51.2"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T00:00:00Z","timestamp":1668470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Watchman device is the most widely used occluder but is indicated in atrial fibrillation (AF) patients with a maximal left atrial appendage (LAA) orifice diameter between 17 and 31\u2009mm. We aimed to compare the long\u2010term safety and efficacy of left atrial appendage\u00a0closure (LAAC) between patients with a small LAA (&lt;17\u2009mm) and those with an indicated LAA (17\u201331\u2009mm) measured by transesophageal echocardiography (TEE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 369 AF\u00a0patients treated with LAAC between March 2015 and February 2019 were included and divided into two groups based on the maximal LAA orifice diameter measured by TEE: small LAA group (<jats:italic>n<\/jats:italic>\u2009=\u200922) and indicated LAA group (<jats:italic>n<\/jats:italic>\u2009=\u2009347). Periprocedural complications and long\u2010term clinical outcomes were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Watchman device was successfully implanted in all patients. Mean device compression was higher in the small LAA group. Four patients (1.2%) in the indicated LAA group experienced pericardial effusion, and none experienced pericardial effusion in the small LAA group. Device\u2010related thrombus was detected in one (4.5%) patient in the small LAA group and five (1.4%) in the indicated LAA group (<jats:italic>p<\/jats:italic>\u2009=\u2009.310). After a mean follow\u2010up period of 4.1\u2009\u00b1\u20091.6 years, one patient in the small LAA group (4.5%; 1.1\/100 person\u2010years) and four in the indicated LAA group (1.2%; 0.3\/100 person\u2010years) suffered an ischemic stroke (<jats:italic>p<\/jats:italic>\u2009=\u2009.266).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The safety and efficacy of LAAC with the Watchman device were comparable between patients with small and indicated LAA orifice diameters measured by TEE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23950","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T18:55:27Z","timestamp":1668538527000},"page":"134-141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long\u2010term safety and efficacy of left atrial appendage closure in patients with small appendage orifices measured with transesophageal 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