Chair Bradley Knight (Chicago, US) led a session on percutaneous left atrial appendage (LAA) closure, featuring the laminar device. Presented by Devi Nair (Jonesboro, US) with panellists Rodney Horton (Austin, US), Oussama Wazni (Cleveland, US), and Luigi Di Biase (New York, US), the session demonstrated how the laminar device uses a rotating ball mechanism to exclude rather than occlude the LAA. The device, under investigation in an IDE trial, has a steerable guide and multiple control knobs for precise deployment. A patient with atrial fibrillation and a high CHA₂DS₂-VASc score was treated using an inferior-posterior transeptal approach. Seal criteria were assessed via echocardiography and contrast angiography, confirming successful LAA exclusion.

The panel discussed the device’s smaller footprint, reduced risk of device-related thrombosis, and contrast use minimisation through echocardiography. They debated safety concerns around tissue manipulation, anticoagulation strategies (currently 45 days of dual antiplatelet therapy), and the impact of different transeptal approaches, particularly for anterior chicken wing anatomies. The session concluded with a preview of a more complex case addressing further challenges with laminar deployment.