{"id":393,"date":"2026-01-09T03:29:43","date_gmt":"2026-01-09T03:29:43","guid":{"rendered":"https:\/\/kishiwada.tokushukai.or.jp\/en\/?page_id=393"},"modified":"2026-04-11T03:56:07","modified_gmt":"2026-04-11T03:56:07","slug":"left-atrial-appendage-closure-watchman","status":"publish","type":"page","link":"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/cardiology\/left-atrial-appendage-closure-watchman\/","title":{"rendered":"Left Atrial Appendage Closure \u2014 WATCHMAN"},"content":{"rendered":"

<\/p>\n

\n
\n
\n
WATCHMAN procedures (2024)<\/div>\n
28 \u2014 significant increase from 7 in 2023<\/div>\n<\/p><\/div>\n
\n
Indication<\/div>\n
Atrial fibrillation with stroke risk \u2014 when anticoagulation is not suitable<\/div>\n<\/p><\/div>\n
\n
Approach<\/div>\n
Catheter-based \u2014 no open surgery, femoral vein access<\/div>\n<\/p><\/div>\n
\n
Benefit<\/div>\n
Reduces stroke risk without long-term anticoagulation<\/div>\n<\/p><\/div>\n<\/p><\/div>\n

\n Left atrial appendage closure using the WATCHMAN device is performed at Kishiwada Tokushukai
\n for patients with atrial fibrillation who face high stroke risk but cannot safely take
\n long-term anticoagulation therapy. With 28 procedures in 2024 \u2014 a fourfold increase from 2023 \u2014
\n the programme is one of the most active in the region.\n <\/p>\n

\n
\n
\n

Why the left atrial appendage matters<\/h2>\n<\/p><\/div>\n
\n

\n In patients with atrial fibrillation, the left atrial appendage \u2014 a small pouch
\n in the upper left chamber of the heart \u2014 is the site where over 90% of cardiac blood clots form.
\n These clots can travel to the brain and cause stroke.\n <\/p>\n

\n Standard treatment involves long-term anticoagulant medication (blood thinners)
\n to prevent clot formation. However, some patients cannot tolerate anticoagulants
\n due to high bleeding risk, prior major bleeding, or other medical conditions.
\n For these patients, closing the left atrial appendage physically is an alternative strategy.\n <\/p>\n<\/p><\/div>\n<\/p><\/div>\n

\n
\n

The WATCHMAN procedure<\/h2>\n<\/p><\/div>\n
\n

\n WATCHMAN is a small plug-like device delivered through a catheter inserted
\n into the femoral vein in the groin. Under general anaesthesia and guided by
\n transoesophageal echocardiography, the device is positioned within the left atrial appendage
\n to seal it off. The procedure takes approximately one to two hours.
\n Over time, the heart’s own tissue grows over the device, permanently sealing the appendage.\n <\/p>\n

\n Following the procedure, a short course of anticoagulation is usually required
\n while the device surface heals. Long-term anticoagulation can typically
\n be discontinued after approximately 45 days, subject to echocardiographic confirmation.\n <\/p>\n<\/p><\/div>\n<\/p><\/div>\n

\n
\n

Who is a candidate?<\/h2>\n<\/p><\/div>\n
\n

\n WATCHMAN may be appropriate for patients with atrial fibrillation who have
\n an elevated stroke risk score (CHA\u2082DS\u2082-VASc \u22652) and meet one or more of the following:\n <\/p>\n

\n