Thank you for joining us for the March 2022 case scenario for the LAAO registry. Today we will be discussing the follow-up requirements when a complication arises necessitating the removal of the device while still in the base procedure episode of care. An 81-year-old female presents to the facility for the insertion of a left atrial appendage occlusion device. The patient has a history of an ischemic stroke one year ago with minimal residuals and a history of permanent atrial fibrillation, which was non-responsive to multiple cardioversion attempts. During insertion of the device, the left atrium was punctured. The patient developed an immediate pericardial effusion with hemodynamic compromise. The patient was emergently taken to open-heart surgery for successful repair of the atrial puncture and removal of the left atrial appendage device. Our question is, would the patient require a 45-day follow-up since the device was removed in the base episode of care? Number one, no, or number two, yes. Please take a moment to review the documentation and question to determine the best answer. And the answer is number one, yes. For the purpose of the LAAO registry, if the newly implanted Watchman is explanted during the same episode of care prior to discharge, the patient will only require a 45-day follow-up. The assessments performed during the follow-up will be under the discretion of the following clinician. If any assessments are not performed, please just code as no, not assessed, or not drawn. Our bonus question, since the LAA device was removed during the base procedure and the 45-day follow-up is required, will the patient require a 6-month, 1-year, and or 2-year follow-up? The answer is the 6-month, 1-year, and 2-year follow-up would not be required since the device was removed prior to discharge. A second bonus question with a slightly different device removal timeframe. If the patient has a device explant after discharge, will they require a 45-day, 6-month, 1-year, and 2-year follow-up? And the answer, if the patient's device was explanted after discharge, the patient will only need the next follow-up interval assessment. If the device is explanted after the 45-day follow-up, please capture on the 6-month follow-up and no other follow-ups will be needed. Thank you for reviewing the LAAO Registries Case Scenario for March 2022. We'll see you next month.

LAAO Registry

complication

device removal

follow-up requirements

left atrial appendage occlusion