The session, chaired by Devi Nair (Jonesboro, US), featured a recorded case of left atrial appendage (LAA) exclusion using a novel ball-and-lock device. Dr Nair, who performed the procedure at St Bernards Heart & Vascular Center (Jonesboro, US), explained the device's mechanism, which rotates and locks the appendage to fully exclude it. She detailed the procedural setup, including the steerable guide, stabiliser, and delivery system, as well as the sizing criteria for device selection. The panel, consisting of David DeLurgio (Atlanta, US), Moussa Mansour (Boston, US), and Dinesh Sharma (Naples, US), discussed patient selection, device adaptability, and procedural nuances. Pre-procedural imaging, including CT and transesophageal echocardiography (TEE), was highlighted for accurate measurements.

The case involved a 71-year-old male with recurrent GI bleeds and a high CHA₂DS₂-VASc score, randomised to receive the device as part of an investigational trial. Dr Nair demonstrated transseptal puncture, device deployment, and rotational closure under TEE and fluoroscopic guidance. Complete LAA exclusion was confirmed using angiography and echocardiography. The panel explored the device’s adaptability across different anatomies, its impact on atrial electrical activity, and clinical trial outcomes.