Failure of Complete Endothelialization of a Watchman Device 3 Years Post-Implantation

Uyanga Batnyam; Alexandra Tuluca; Christian F Witzke; Allan M Greenspan; Sumeet K Mainigi

doi:10.1016/j.jaccas.2020.09.022

Failure of Complete Endothelialization of a Watchman Device 3 Years Post-Implantation

JACC Case Rep. 2020 Nov 11;3(2):319-321. doi: 10.1016/j.jaccas.2020.09.022. eCollection 2021 Feb.

Authors

Uyanga Batnyam¹, Alexandra Tuluca^{1

2}, Christian F Witzke¹, Allan M Greenspan¹, Sumeet K Mainigi^{1

2}

Affiliations

¹ Division of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
² Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Abstract

We report an unusual case of incomplete endothelialization of the Watchman device >3 years after its implantation. Animal data suggest that device endothelialization occurs ∼45 days post-implantation; however, data on humans are lacking. Guidelines on anticoagulation are based on expectation from animal studies. (Level of Difficulty: Advanced.).

Keywords: MR, mitral regurgitation; MVR, mitral valve replacement; TEE, transesophageal echocardiogram; Watchman device; atrial fibrillation; endothelialization; incomplete endothelialization; left atrial appendage occlusion device; membrane healing.