Transesophageal Echocardiography to Diagnose Watchman Device Infection

Jensen, Joseph; Thaler, Christina; Saxena, Retu; Calcaterra, Domenico; Sánchez, J Martín; Orlandi, Quirino; Harris, Kevin M.

doi:10.1016/j.case.2020.01.008

Cited by 9 publications

(14 citation statements)

References 7 publications

(5 reference statements)

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“…Transesophageal echocardiography (TEE) showed extensive vegetation on the Watchman device, which was treated surgically. 8 Here, we present a case report of a patient who underwent LAA occlusion with a Watchman FLX device, with subsequent development of Staphylococcus aureus bacteremia due to a lower extremity wound.…”

Section: Introductionmentioning

confidence: 98%

Large Cystic Intracardiac Mass Overlying Left Atrial Appendage Occlusion Device: A Case Report and Literature Review

Joury

Abelhad

Kelly

et al. 2021

CASE

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Section: Introductionmentioning

confidence: 98%

Large Cystic Intracardiac Mass Overlying Left Atrial Appendage Occlusion Device: A Case Report and Literature Review

Joury

Abelhad

Kelly

et al. 2021

CASE

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“…There are rare case reports of WD-associated infection [1][2][3]. While the original Watchman trials reported on adverse outcomes broadly, they did not directly report on DOI: 10.1159/000516400 the incidence of WD-related infections or outcomes in the setting of blood stream infections (BSI) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Infection Rate and Outcomes of Watchman Devices: Results from a Single-Center 14-Year Experience

et al. 2021

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The Watchman device (WD) is a commonly used alternative strategy to oral anticoagulation for stroke risk reduction in patients with atrial fibrillation who have an increased bleeding risk. There are rare case reports of WD-related infection. Currently, there is no formal study that has systematically evaluated the incidence and outcomes WD-related infections. The objective of this study was to evaluate the incidence, risk factors, and outcomes for WD-associated infections in a single-center cohort over a 14-year period. All patients who underwent WD implantation over a 14-year study period (July 2004 through December 2018) comprised our cohort. Baseline characteristics, procedural data, and postimplantation events were identified through a retrospective chart review. Primary study outcomes included WD-related infection, other cardiovascular device-related infection, bacteremia, and mortality. A total of 181 patients (119 males; 65.7%) with a mean age of 75 years at implantation were included in the analysis. A total of 534.7 patient years of follow-up was accrued, with an average of 2.9 years per patient. The most common indications for implantation included gastrointestinal bleeding (56 patients; 30.9%) and intracerebral bleeding (51 patients; 28.2%). During the follow-up period, 37 (20.4%) patients died. Six developed evidence of bacteremia. Only 1 developed an implantable cardioverter defibrillator infection that required a complete system extraction. None of the cohort developed a WD-related device infection during the study period. We concluded that there is a low risk of WD-related infection even in the setting of a blood stream infection.

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“…There are rare case reports of WD-associated infection [1][2][3]. While the original Watchman trials reported on adverse outcomes broadly, they did not directly report on the incidence of WD-related infections or outcomes in the setting of blood-stream infections (BSI) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Infection Rate and Outcomes of Watchman Devices: Results from a Single Center 14-Year Experience

Ward

McGill

Adel

et al. 2020

Preprint

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Background: Left atrial appendage occlusion with the Watchman device is an alternative strategy for stroke risk reduction in patients with non-valvular atrial fibrillation. There are rare case reports of Watchman associated infection. Currently, there is no formal study that evaluated the incidence and outcomes of Watchman-related infections. Methods: All patients who underwent Watchman implantation over a 14 year study period (July 2004 through December 2018) comprised our cohort. Baseline characteristics, procedural data, and post-implantation events were identified. Primary study outcomes included Watchman related infection, other cardiovascular device related infection, bacteremia, and mortality. Results: A total of 181 patients with an average age of 75, and a median CHA2DS2-VASc Score of 4 (interquartile range 2) and a median HAS-BLED Score of 3 (interquartile range 1), were included for analysis. A total of 534.7 patient years of follow up was accrued with an average of 2.9 years per patient. The most common indications for implantation included gastrointestinal bleeding (56 patients; 30.9%) and intracerebral bleeding (51 patients; 28.2%). During follow up, 38 patients (21%) died. Six developed evidence of bacteremia. Only one developed an implantable cardioverter defibrillator (ICD) infection that required complete system extraction. None of the cohort developed Watchman-related device infection during the study period. Conclusion: In a single center study spanning a 14 year period, we report no Watchman-related devices infections. This is despite the presence of patients with bacteremia, as well as an ICD infection requiring extraction. These data suggest that Watchman devices are extremely unlikely to become infected.

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Transesophageal Echocardiography to Diagnose Watchman Device Infection

Cited by 9 publications

References 7 publications

Large Cystic Intracardiac Mass Overlying Left Atrial Appendage Occlusion Device: A Case Report and Literature Review

Large Cystic Intracardiac Mass Overlying Left Atrial Appendage Occlusion Device: A Case Report and Literature Review

Infection Rate and Outcomes of Watchman Devices: Results from a Single-Center 14-Year Experience

Infection Rate and Outcomes of Watchman Devices: Results from a Single Center 14-Year Experience

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