Introduction: To evaluate the impact of pulmonary ridge (PR) coverage on both clinical and imaging follow-up outcomes in patients undergoing left atrial appendage occlusion (LAAO).
Methods and Results: The study included consecutive patients with non-valvular atrial fibrillation who underwent LAAO with disc and lobe devices. Patients were classified in two groups according to the PR coverage. A total of 147 patients were included. Among them, PR was covered in 109 (74%) and uncovered in 38 (26%). Successful implantation was achieved in 98.6%. No differences in procedural outcomes were observed among groups. The rate of procedural major adverse events was 3% (only major bleedings and/or vascular access complications). No device embolization, cardiac tamponade or in-hospital mortality was observed. After a mean follow-up of 1.77±2.2 years, the annualized ischemic stroke and major bleeding rate was 1.3%/year and 6.5%/year respectively without differences among groups. At follow-up, patients with a covered PR presented a lower incidence of device related thrombosis (DRT) (1%) than those with uncovered PR (27%); p<0.001. In multivariable analysis, the presence of PR coverage emerged as an independent predictor of DRT.
Conclusions: Pulmonary ridge coverage was associated with a lower incidence of DRT after LAAO. Procedural and follow-up clinical outcomes did not differ among covered-PR and uncovered-PR patients.