Outcomes of Combined Left Atrial Appendage Occlusion and Transcatheter Mitral Edge-to-Edge Repair
Bibliographic record
Abstract
Background: Up to 50% of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) have an indication for left atrial appendage occlusion (LAAO). However, prospective evaluation of this strategy is lacking. Objectives: The aim of the study was to prospectively evaluate the outcomes of combined LAAO and MTEER. Methods: The WATCH-TEER study is a prospective multicenter registry that aims to assess the feasibility and safety of concomitant MTEER with MitraClip and LAAO with WATCHMAN-FLX in patients with an approved clinical indication for both procedures. The primary endpoint was a composite of all-cause mortality, stroke, life-threatening, or major bleeding at 45 days. Results: A total of 24 patients were included between October 2020 and March 2024. Mean age was 79.5 ± 6.3 years, and 83% were males. The Society of Thoracic Surgeons operative risk score was 11.8% ± 5.3%, the CHA2DS2-VASc score was 4.5 ± 1.1, and the HAS-BLED score was 3.3 ± 1.5. Total procedure time was 103.6 ± 33.7 minutes. At 45 days, the primary endpoint occurred in 21% (95% CI: 5%-37%, n = 5/24) of patients, all of which occurred after discharge including 1 cardiac death, 1 ischemic stroke, 1 trauma-related intracranial hemorrhage, and 2 nonprocedural major bleeds. At 45 days, most patients (68%) had ≤2+ mitral regurgitation, and 72% of patients were in NYHA functional class I-II symptoms. Additionally, 71% of patients were not on anticoagulation, compared with only 20% at baseline. Conclusions: Combining LAAO with MTEER is feasible in patients who have a clinical indication for both procedures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".