Periprocedural aspects and TEE follow-up
LAAC was successfully performed in all patients, and all 220 (100.0%)
patients in the DAPT group were discharged on DAPT. In the ACT group,
270 (88.8%) patients were discharged on LMWH plus aspirin and 34
(11.2%) patients on OAC plus aspirin. Procedure-related events are
summarized in Table 2, and all patients were managed conservatively
without sequelae. TEE was available for 190 (86.4%) patients in the
DAPT and 267 (87.8%) in the ACT group, respectively (Table 3). The
number of major (≥5 mm) peri-device leak was three (1.1%) in the ACT
group and two (1.1%) in the DAPT group. Among those cases, one patient
in the ACT group had TIA despite treatment with a NOAC. DRT was detected
in 13/267 (4.9%) patients in the ACT group and 5/190 (2.6%) in the
DAPT group. Among thirteen cases of DRT in the ACT group, ten received
NOAC, and the others resumed aspirin plus warfarin. Of those, nine were
resolved in repeat TEE exams. In the DAPT group, all five cases of DRT
were treated with NOAC, and two were resolved according to TEE
follow-up. In two cases, TEE control was refused. In both groups, none
of the cases with DRT resulted in clinical adverse events. In the ACT
group, DRT was associated with two ischaemic disabling strokes, despite
the fact that one patient was still under OAC.