{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:20:36Z","timestamp":1784931636532,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We evaluated the efficacy of a new method in identifying peri\u2010device leak (PDL) using morphology of the thrombus formed inside the left atrial appendage (LAA) as seen on follow\u2010up transesophageal echo (TEE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A total of 291 consecutive patients undergoing Watchman procedure were included in this analysis. TEE was performed at 45 days postprocedure. Based on the presence of the thrombus inside the LAA behind the device, patients were grouped as (1) white (W) group: LAA completely filled with thrombus (<jats:italic>n<\/jats:italic>\u2009=\u2009101), 2) nonwhite (NW) group: LAA completely black or mixed (part black and part white;\u00a0<jats:italic>n<\/jats:italic>\u2009=\u2009190). Follow\u2010up TEE was repeated at 6 and 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were comparable between groups except the device size, number of patients with chicken\u2010wing morphology, and prevalence of left atrial \u201csmoke\u201d that were significantly higher in the NW group. Detection of black appearance was comparable between the pre\u2010coil closure image and the NW population (26\/36 [72.2%]\u00a0vs 99\/154 [64.3%], <jats:italic>p<\/jats:italic>\u2009=\u2009.37). After adjusting for clinically relevant covariates, NW appearance of the LAA was associated with the presence of significant leak (odds ratio: 47.96, 95% confidence interval: 2.91\u2013790.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The 11 patients with mixed appearance at the 6\u2010month TEE remained unchanged (part black and part white) at the 12\u2010month TEE. LAA appearance was white in all 36 patients following coil closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings demonstrated white and nonwhite appearance of the appendage on TEE to be reliable markers of complete closure and leak respectively, following LAA occlusion with the Watchman device.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14641","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T07:31:56Z","timestamp":1593415916000},"page":"2338-2343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A simple method to detect leaks after left atrial appendage occlusion with Watchman"],"prefix":"10.1111","volume":"31","author":[{"given":"H\u00fcseyin","family":"Ayhan","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-944X","authenticated-orcid":false,"given":"Sanghamitra","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"},{"name":"Department of Internal Medicine Dell Medical School  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Gedikli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ondokuz Mayis University Medicine School  Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-1706","authenticated-orcid":false,"given":"Ugur","family":"Canpolat","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hacettepe University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo Chauca","family":"Tapia","sequence":"additional","affiliation":[{"name":"Department of Cardiology UHPM  Cardiz Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-3462","authenticated-orcid":false,"given":"Domenico G.","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-7207","authenticated-orcid":false,"given":"Carola","family":"Gianni","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Salwan","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisara","family":"Annanab","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Mayedo","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. David","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Horton","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald J.","family":"Gallinghouse","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"},{"name":"Department of Cardiology Albert Einstein College of Medicine at Montefiore Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Al\u2010Ahmad","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0728","authenticated-orcid":false,"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, St. David's Medical Center Texas Cardiac Arrhythmia Institute  Austin Texas USA"},{"name":"Department of Internal Medicine Dell Medical School  Austin Texas USA"},{"name":"Division of Electrophysiology Interventional Electrophysiology, Scripps Clinic  San Diego California USA"},{"name":"Department of Electrophysiology, Metro Health 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