Excerpt

The Watchman device (WD) (Boston Scientific, Natick, Massachusetts) for left atrial appendage (LAA) closure recently gained approval in the United States. Randomized trials and observational studies demonstrated it as a viable alternative to anticoagulation for stroke reduction in the setting of non-valvular atrial fibrillation. Fluoroscopic and transesophageal (TEE) guidance are used frequently for guidance. They are confined by spatial resolution, obscuring complete LAA definition. Cardiac computed tomography angiography improves this problem in addition to better three-dimensional (3D) features [1]. Given that the procedures are typically performed under general anesthesia, there are advantages to pre-procedural planning to facilitate success. This includes the need to check for significant compression of the device (8–20 %) to prevent residual leak [2]. …