Left Atrial Appendage Occlusion: Analyzing Factors for Peridevice Leak with Dual-Occlusive Devices

Background: This study examines factors influencing peridevice leak (PDL) in patients treated with the Amplatzer Amulet Occluder for left atrial appendage occlusion (LAAO). Materials and Methods: A retrospective analysis was conducted on 217 patients who underwent successful LAAO with the Amplatzer Amulet Occluder due to atrial fibrillation and anticoagulation contraindications. Follow-up transesophageal echocardiography (TEE) was performed 1-3 months post-procedure to detect PDL and analyze related procedural and anatomical factors. Results: PDL occurred in 42% of patients, predominantly mild (<3 mm). Key factors associated with increased PDL risk included occluder compression <12%, off-axis device positioning, and device size ≥25 mm. Baseline patient characteristics and procedural details did not significantly impact PDL rates. Conclusion: For optimal LAAO outcomes, pre- and periprocedural assessment of LAA size and device positioning is crucial. Ensuring occluder compression above 15% may minimize PDL risks, especially for larger devices.