Valvular & structural heart diseaseResearch article

Impact of device implantation depth on blood flow dynamics after left atrial appendage closure

EuroInterventionPublished

  • patient-specific computational fluid dynamics (CFD)
  • 10 centres

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
CFD-derived flow indices between proximal and distal device implantation groups
Outcome
CFD-derived flow indices (DSVI, ECAP, presence of eddies/stagnated flow)

Main finding

As reported in the abstract

recirculating zones

OutcomeProximal implantsDistal implants
DSVI0.11 m/s0.09 m/s
ECAP0.750.90

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:10.4244/eij-d-25-01328

Summarised from the published abstract; every number is checked against it