Procedures
The LAAC devices used in this study were the Watchman
2.5TM Devices and the Watchman FLXTMdevices (Boston scientific, St. Paul, Minnesota) using the TruSeal
access sheath (Boston Scientific, St. Paul, Minnesota). The basic steps
of the procedure were similar for the Watchman 2.5TMand FLXTM devices regarding the use of general
anesthesia, femoral venous access for the transseptal puncture, use of a
guide wire and pigtail for sheath guidance and positioning, and device
selection based on transesophageal echocardiography (TEE) and
angiography. Implantation of the Watchman 2.5TMdevices was performed as recommended (22), and the ball technique was
used for the implantation of the Watchman FLX devices (22). After
correct TEE assessment of the standard PASS criteria (position, anchor,
size/compression, seal), fluoroscopic morphology and angiographic test,
a tug-test was performed. The Watchman device was then released, and all
material removed. Patients could receive protamine infusion and venous
closure device, or hemostatic suture and a compressive dressing.