SHENG-NAN CHANGChiu, Fu-ChunFu-ChunChiuJIEN-JIUN CHENPANG-SHUO HUANGTING TSE LINHSIAO-LIANG CHENGTsai, Chin-FengChin-FengTsaiYI-CHIH WANGCHIA-TI TSAI2023-03-102023-03-102022-1127723747https://scholars.lib.ntu.edu.tw/handle/123456789/629199Left atrial appendage (LAA) closure (LAAC) device implantation may be challenging in cases with difficult LAA anatomy. A deflectable sheath to approach multiple LAA positions may be helpful. We used a deflectable sheath to implant LAAC devices in 20 patients and included 60 cases using the standard sheaths for comparison. The procedures were successful in all patients without peri-procedural complications. After a median follow-up of 1.52 (IQR: 0.76-2.33) years, none of the patients in the deflectable sheath group had peri-device leak ≥3 mm and experienced thromboembolic stroke. In the standard sheath group, after follow-up of 2.03 (IQR: 0.87-3.19) years, 2 had peri-device leak ≥3 mm and 1 experienced thromboembolic stroke. We first proved the idea of using a universal steerable sheath for LAAC device implantation in difficult LAA anatomy, which also allows rapid switching of different LAAC devices.enAF, atrial fibrillation; LAA, left atrial appendage; LAAC, left atrial appendage closure; deflectable sheath; left atrial appendage closure device; steerable sheath[SDGs]SDG3journal article10.1016/j.jacasi.2022.08.003364443202-s2.0-85141682025