Citations 2
Comparison of Flow Dynamics After Left Atrial Appendage Occlusion With the Watchman FLX Versus Amulet Devices: Implications for Device‐Related Thrombosis
Bshennaty, Ahmad , Vogl, Brennan , Bavo, Alessandra , Ghazal‐Aswad, Karam, Kramer, Anders , Jia, Yuheng , Beule, Matthieu De , Nielsen‐Kudsk, Jens Erik , Saleh, Ghasaq, Bavo, Alessandra Maria , Sularz, Agata , Ghazal-Aswad, Karam, Jia, Yuheng , De Backer, Ole , Hatoum, Hoda , Kramer, Anders Dahl , Saleh, Ghasaq , Sularz, Agata , Backer, Ole De , Alkhouli, Mohamad , Hatoum, Hoda
Catheterization and Cardiovascular Interventions | June 25, 2025 | Volume: 106 | Issue: 4 | Pages: 2084-2092
ABSTRACT Background This study aims to assess how Watchman FLX (Boston Scientific) and Amplatzer Amulet (Abbott) devices for left atrial appendage occlusion (LAAO) impact the flow dynamics in the LA and the risk of device‐related thrombosis (DRT). Methods Flow simulations were carried out for 12 AF patients before and after undergoing LAAO. Six patients had Watchman FLX while the other six had Amulet devices, of which three in each group had DRT. The flow parameters investigated included the LA velocities, pressure, time averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT). Low TAWSS and high OSI and RRT are generally associated with flow stasis and thrombosis. Results LA flow dynamics differed significantly between the two groups. On average, after LAAO, the Amulet patients exhibited a 25% increase in TAWSS and 24% decrease in RRT while the Watchman FLX patients exhibited, on average, a 24% decrease in TAWSS and a 23% increase in RRT. Both populations experienced an increase in LA pressure (~10% for Amulet patients and 16% for Watchman FLX patients). Increased DRT volume seems to be correlated with low TAWSS and elevated RRT. Conclusion This preliminary study suggests that the Amulet device might be associated with improved LA flow dynamics and a potentially lower incidence of DRT compared with the Watchman. However, a larger clinical study is needed to confirm these findings.
Understanding the role of the left atrial appendage on the flow in the atrium
Bshennaty, Ahmad , Vogl, Brennan , Bavo, Alessandra , Kramer, Anders , Jia, Yuheng, Beule, Matthieu De , Nielsen‐Kudsk, Jens Erik , Backer, Ole De , Alkhouli, Mohamad , Bavo, Alessandra Maria , Sularz, Agata , Kramer, Anders Dahl , De Backer, Ole , Hatoum, Hoda , Sularz, Agata , Alkhouli, Mohamad , Hatoum, Hoda
Catheterization and Cardiovascular Interventions | July 21, 2024 | Volume: 104 | Issue: 6 | Pages: 1290-1298
Abstract Background The exclusion/occlusion of the left atrial appendage (LAA) is a treatment option for atrial fibrillation (AF) patients who are at high risk of stroke and high risk of bleeding. As the role of the LAA is not well understood or explored, this study aims to assess its role on flow dynamics in the left atrium. Methods Computational fluid dynamics (CFD) simulations were carried out for nine AF patients before and after LAA exclusion. The flow parameters investigated included the LA velocities, Time Averaged Wall Shear Stress (TAWSS), Oscillatory Shear Index (OSI), Relative Residence Time (RRT), and Pressure in the LA. Results This study shows that, on average, a decrease in TAWSS (1.82 ± 1.85 Pa to 1.27 ± 0.96 Pa, p < 0.05) and a slight increase in OSI (0.16 ± 0.10 to 0.17 ± 0.10, p < 0.05), RRT (1.87 ± 1.84 Pa −1 to 2.11 ± 1.78 Pa −1 , p < 0.05), and pressure (−19.2 ± 6.8 mmHg to −15.3 ± 8.3 mmHg, p < 0.05) were observed in the LA after the exclusion of the LAA, with a decrease in low‐magnitude velocities. Conclusion The exclusion of the LAA seems to be associated with changes in LA flow dynamics. Further studies are needed to elucidate the clinical implications of these changes.