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.