Post procedural management and follow up
Post procedural anti-thrombotic management is also listed inTable 2 . All patients were discharged on post-procedural day 1.
The two patients who received a WATCHMAN device were discharged with
aspirin and an anticoagulant. One patient who received an Amplatzer had
been noted previously to have a LAA thrombus that resolved with
apixaban, and he was maintained on apixaban after device placement. The
two other patients who had an Amplatzer placed were discharged on ASA
and clopidogrel (Table 2 ).
Follow up TEE was performed ≥ 6 weeks after device placement. In the 4
ISLL patients, no residual leaks were noted and no device related
thrombus was present. In the fifth patient who had a WATCHMAN and
Amplatzer in place, a small leak was noted by TEE (< 4mm) with
no thrombus. Patients on an anticoagulant were transitioned to
aspirin/clopidogrel for an additional 6 weeks, then transitioned to
aspirin monotherapy. The median follow up time since closure of the
residual connection was 888 days (range 468 – 1490 days). No strokes or
systemic embolic events occurred. One patient had recurrent GIB
requiring transfusion on dual antiplatelet therapy 8 weeks after device
placement and clopidogrel was stopped.