Learning Curve Assessment for Percutaneous Left Atrial Appendage Closure With the WATCHMAN Occluder

Abstract

With increasing operator experience the performance and safety of percutaneous LAA closure improved continuously.

Left Atrial Appendage Closure With the New Occlutech® Device: First in Man Experience and Neurological Outcome

“…reported on a fluoroscopy time of 20 minutes for their first 30 patients. The following patients had a fluoroscopy time of 11 minutes . In comparison, Koskinas et al .…”

Comparative Safety and Efficacy of Left Atrial Appendage Occlusion with the Watchman Device and Amplatzer Cardiac Plug: Results of the Russian National Registry

“…The observed major adverse event rate in the ACP group (6.5%) was higher than that reported in the large multicenter trial with the Amplatzer Cardiac Plug ( n = 1047) by Tzikas et al (4.97%) [ 10 ]. Such high rate is most likely related to the concept of the learning curve [ 11 , 12 ]. This government-funded catheter-based LAAO program in Russia started in September 2015, and a certain lack of experience existed at that time; two of five clinics had no previous experience of LAAO procedures.…”

“…Moreover, the authors noticed that initial experience of LAAO using ACP also translated into better safety and efficacy outcomes for the WD [ 11 ]. The absence of additional disk in WD perhaps simplified the implantation procedure using the WD and therefore the complication rate [ 12 ]. In our study, no major adverse events occurred in the WD group, which correlated well with data from the EWOLUTION registry [ 13 ].…”

Posicionamento da Sociedade Brasileira de Cardiologia e da Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista sobre Centro de Treinamento e Certificação Profissional em Hemodinâmica e Cardiologia Intervencionista – 2020

“…The duration of the learning curve for LAAO varies significantly, in accordance with the operator's degree of familiarity with congenital and/or structural heart disease procedures and the frequency with which the procedure is performed. There is no consensus in the literature with respect to the minimum number of cases required in order to complete this learning curve; 39,40 nevertheless, within the Brazilian context, considering the complexity of the intervention, the practical experience of the authors of these guidelines has made it possible to estimate that a beginner operator reaches the level of proficiency and safety necessary for LAAO once he or she has performed approximately ten cases. Although all of the prostheses available in the Brazilian market follow different requirements and implantation techniques, there is a "group effect" in learning the general technique, which allows for partial sharing of the learning curves between prosteses.…”