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WATCHMAN initial deployment.
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TEE assessment, a 24-mm device was deployed and released. There was no leak visualized acutely after deployment (Figure 1).
WATCHMAN at 25 days.
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TEE was performed approximately 25 days postprocedure. This revealed a well-seated WATCHMAN device with no peridevice leak. There was no evidence of left atrial thrombus (Figure 2).
WATCHMAN at 11.5 weeks, showing layered and mobile thrombus.
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TAVR with a 20-mm Sapien XT valve (Edwards Lifesciences, Irvine, CA). TEE performed after deployment revealed a large layered thrombus across the entirety of the WATCHMAN device along with a large mobile portion extending into the left atrium (Figure 3). The patient was given heparin drip along with warfarin.