Seize the day, …s(e)ize the device: The emerging imaging modality to improve left atrial appendage device sizing

There is still uncertainity about the use of computed tomography-scan for left atrial appendage occlusion (LAAO) device sizing. The main reason for this disappointing position is likely to relate to the scarcity of robust data, since there is still difference among institutions with regards how to perform measurement of the devices. Dallan et al. report their own experience on the use of a novel computed tomography angiography-based (CTA) for sizing the Watchman Flex device for LAAO. The authors through the TruPlan software package that a preprocedural CTA sizing protocol can be applied successfully with intracardiac echocardiography guidance and provide excellent procedural outcomes. The applied CTA protocol is safe and can provide high success rates with the WatchmanTM FLX device reducing the number of deployment attempts and reducing the risk of complications.