Valvular & structural heart disease
Impact of device implantation depth on blood flow dynamics after left atrial appendage closure
Authors' conclusion
Deeper LAAC device implantation is associated with adverse flow profiles and a higher risk of DRT. CFD-based flow characterisation may enhance risk stratification beyond anatomical criteria alone. Further studies incorporating clinical variables are warranted to validate these methods.
Study context
- Population
- Patients undergoing left atrial appendage closure (LAAC) with either Amplatzer Amulet or WATCHMAN devicespatients undergoing LAAC
- Participants
- 285 patients
- Comparison
- Computational fluid dynamics (CFD)-derived flow indices between proximal and distal device implantation groups
- Outcome
- CFD-derived flow indices (DSVI, ECAP, presence of eddies/stagnated flow)
Methodological detailsCFD, 10 centres
- CFD
- 10 centres
Main finding
As reported in the abstract
Recirculating zones
| Outcome | Proximal implants | Distal implants |
|---|---|---|
| DSVI | 0.11 m/s | 0.09 m/s |
| ECAP | 0.75 | 0.90 |
Further findings
Device-related thrombus (DRT) incidence by implantation depth
- DRT incidence increased with greater implantation depth, paralleled by worsening flow indices
Discrimination of composite CFD-based DRT risk score
- Composite CFD-based DRT risk score AUC
- 0.81
- Anatomical depth alone AUC
- 0.71
Original publication
Impact of device implantation depth on blood flow dynamics after left atrial appendage closure. EuroIntervention. Published 20 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it