In this case, Dr. Robert A. VerNooy Jr. highlights the implantation of a left atrial appendage occlusion, to reduce stroke risk in a patient that could not tolerate the use of long-term blood thinners.
I'm doctor Robert Vanoy. I'm a heart rhythm specialist electrophysiologist, practicing here at Centre R. Mh, here in Harrisonburg, Virginia. And today I'm going to present a case on left atrial appendage occlusion implant with the Watchman type device. So this is a left atrial appendage occlusion implant procedure with the Watchman device. We also have another device used called the amulet device and we use the slightly different design characteristics and we use different device for different anatomies. And this is a device that we use in people who can't tolerate long term blood thinners and it reduces the risk of stroke and it plugs up the left atrial appendage where the clots like to form. This is our first imaging within the case with transesophageal echo of the left atrial appendage. It's important to get the size and shape. So we the right device for the right anatomy and, and we are making measurements is very important and then we get into the left atrium, the sheath is already here in the left atrium and we have the device partially deployed in what we call the flex ball position and this is a position we can navigate and still put it, fit it into the left atrial appendage before we fully deploy it and we push it out a little bit more and it expands. You see those barbs grab onto the tissue and keeps it still. But we also want it to compress within the left atrial appendage. And right now, we're assessing to make sure the device is well sealed. There's no leak around the device. We'll check with color flow. This is color flow, we see no leak around the device. The color flow you're seeing in the adjacent left pulmonary vein, we also do a contrast shot just to make sure there's no leak. And the goal is to get a tight seal and a nice fit within the left ear through appendage. So it doesn't migrate and it stays still. And once it's there, we unscrew it and deploy it and this is all done within a 30 45 minute procedure.
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