Figure 1.
Representative examples of patients treated with the standard (A1-A3) or steerable (B1-B3) delivery sheath. Patient A had a cactus-shaped left atrial appendage (LAA), baseline index LA volume = 110 mL/m2, and was treated with 22 mm AMULET device implantation. The follow-up CT scan revealed an off-axis prosthesis (A1-A2) since the lobe was not perpendicular to the appendage wall on the landing zone. In addition, persistent LAA patency was observed (red arrow) in relation to a peridevice leak. Disc/lobe misalignment was also identified (A2) since the axes of the disc (dashed yellow) and the lobe (dashed purple line) intercepted with an angle >30°. Patient B had cactus-shaped LAA, baseline index LA volume = 160 mL/m2, and was treated with 31 mm AMULET device implantation. The device's final position was optimal with the correct apposition of the lobe on the appendage wall. There was no residual LAA patency, nor peridevice leak observed. The disc and lobe were correctly aligned.