LEFT ATRIAL APPENDAGE CRT-600.32 Intracardiac Vs Transesophageal Echocardiography for Percutaneous Left Atrial Appendage Occlusion: An Updated Meta-Analysis Bhavi Pandya, 1 Michael Kost, 2 Katheryne Marchbanks, 2 David Biglari, 3 Rajkumar Sugumaran, 2 Nickalaus Gramze, 2 Todd Hurst, 2 Ligita Centorino, 2 Radha Gopalan, 2 Franciso Arabia, 2 Kenith Fang, 2 Wilber Su, 2 Anantharam kalya, 2 Firas Abbas, 2 Nachiket Patel, 2 George Gellert, 2 Samuel Butman, 4 James Lafferty, 1 Martha Gulati, 2 Divya Ratan Verma 2 1 Staten Island University Hospital Northwell Health, Staten Island, NY; 2 Banner University Medical Center, Phoenix, AZ; 3 Phoenix Veterans Affairs Health Care System, Phoenix, AZ; 4 Heart & Vascular Center of Northern Arizona, Phoenix, AZ BACKGROUND Transesophageal echocardiography (TEE) is standard imaging modality for guiding percutaneous left atrial appendage oc- clusion. Intracardiac echocardiography may be a suitable alternative with advantages like avoiding intubation and general anesthesia METHODS PubMed, EMBASE, and Google Scholar databases were queried for all trials evaluating transesophageal and intracardiac echocardiography for percutaneous left atrial appendage occlusion procedure RESULTS This Meta-analysis included 6 trials and a total of 1261 pa- tients. Transesophageal vs intracardiac echocardiography guidance had similar procedure times (OR -4.23, 95%CI -21.07- 12.61) and similar fluoroscopic times (OR 1.84, 95%CI -0.59- 4.27). Immediate procedural success was also similar for transesophageal vs intracardiac echocar- diographic guidance (OR 1.43, 95%CI 0.75- 2.70). CONCLUSIONS Transesophageal echocardiography and intracardiac echocardiography are both effective and equivalent in proving pro- cedural imaging guidance for percutaneous left atrial appendage occlusion. CRT-600.33 Cardiac Computed Tomography Angiography Preplanning Yields Safety and Feasibility for the Left Atrial Appendage Closure Using the Minimalist Approach Luis Augusto Dallan, Chinedu Angela Igwe, Fahd Naddeem, Anas Fares, Efraim Flam, Gabriel Tensol Rodrigues Pereira, Elder Iarossi Zago, Armando Vergara-Martel, Vladislav Zimin, Brian C. Fitzsimons, Mauricio Arruda, Hiram Grando Bezerra University Hospitals Cleveland Medical Center, Cleveland, OH INTRODUCTION Left atrial appendage closure (LAAC) became a routine interventional procedure worldwide in selected atrial fibrillation cases, together with improvements in the devices’ tech- nologies and optimized implant techniques. The concept of minimalist approach became relevant, aiming at optimal technical implant, fewer perioperative comorbidities, and consequently sooner recovery and less associated risks. Cardiac computed tomography angiography (CCTA) preplanning is an optimal tool to determine the size and shape of the LAA; however, the data in the literature are still scarce. METHODS This was a prospective, all-comers database from a high- volume center, with data collected between September 2018 and September 2019. The aim was to evaluate CCTA preplanning as the standard of care guiding LAAC using the minimalist approach. All patients underwent transesophageal echocardiography (TEE) and CCTA preplanning to determine the size and shape of the LAA, but the devices’ sizes were selected based on the CCTA measurements. Utilized were the Watchman (Boston Scientific, CA) or the Amplatzer Amulet (Abbott Inc, CA) systems. All patients were under local anes- thesia and monitored anesthesia care (MAC) during the procedures, together with bedside pediatric transesophageal echocardiography (TEE) or intra-cardiac echocardiography (ICE) to guide the transseptal puncture, to access LAA imaging and the hemodynamic features. RESULTS We included 40 patients, the mean age was 767.8 years, 60.3% were men, the mean LAA ostium area was 4.9cm 2 and the mean LAA ostium diameter was 80.2mm. Five patients (12%) that would be excluded based on TEE measurements could undergo successful LAAC procedures. All patients (100%) tolerated well the MAC during the procedure. The peri-procedural success rates were 95% (38 pa- tients), with low peri-procedural complication rates (5%), with one device embolization to the aorta (2.5%) and another case of acute pericardial effusion (2.5%), both requiring emergency surgeries. Nevertheless, there were no peri-procedural deaths or strokes. CONCLUSION We conclude that CCTA preplanning for LAAC is feasible and reliable, with high rates of success, yielding LAAC using the minimalist approach. Larger studies are ongoing to evaluate if CCTA could definitely replace TEE in LAAC preplanning. CRT-600.34 Are There Gender Disparities in Presentation and Left Atrial Anatomy in Adults With Atrial Fibrillation Undergoing Watchman Left Atrial Appendage Occlusion? Aditi Malhotra, Puja B. Parikh, Eric Rashba, Neda Dianati Maleki, Hal A. Skopicki, Smadar Kort Stony Brook University Medical Center, Stony Brook, NY INTRODUCTION Left atrial appendage (LAA) occlusion has become the mainstay for treatment in adults with atrial fibrillation (AF) and a high bleeding risk. While accurate device sizing is critical for successful LAA occlusion and optimal clinical outcomes, it is unknown whether gender impacts LAA anatomy and occlusion device size. We sought to examine whether sex-related disparities exist in clinical presentation and left atrial (LA) and LAA anatomy in adults with AF undergoing LAA occlu- sion with a Watchman device (Boston Scientific, MA). METHODS The study population included 62 consecutive patients with AF and high bleeding risk who underwent Watchman LAA oc- clusion device placement from June 2017 to October 2019 at an aca- demic tertiary-care medical center. Baseline demographic, clinical, echocardiographic, and procedural data from all patients was recor- ded. The primary outcome of interest was the size of implanted Watchman devices. RESULTS Of the 62 patients studied, 38 (61.3%) were men and 24 (38.7%) were women. Women had lower body surface area (1.8m 2 vs 2.0m 2 , p<0.001), driven by both lower height (160cm vs 175cm, p<0.001) and weight (77kg vs 88kg, p¼0.028). Women had a higher CHADS2Vasc score (5.5 vs 4.3, p¼0.002) and were more likely to have a history of concomitant bleeding and falls than men (25.0% vs 2.6%, p¼0.043). Rates of hypertension, diabetes mellitus, hyperlipidemia, chronic heart failure, coronary artery disease, vascular disease or prior stroke or thromboembolic events were similar in both genders. Women had smaller left ventricular (LV) internal diameters (4.7cm vs 5.2cm, p¼0.002) and a trend towards higher LV ejection fraction (59% vs 51%, p¼0.064). Women had smaller LA diameters (4.1cm vs 4.5cm, p¼0.026); however, LA area, LA volume, and LA volume index remained similar in both genders. LAA length and width obtained using transesophageal echocardiogram at 0, 45, 90, and 135  were also similar in both men and women. Wind sock was the most common LAA morphology in both men and women, followed by chicken wing and cauliflower. Sizes 24 mm and 27 mm were most common in both men and women. S56 JACC: CARDIOVASCULAR INTERVENTIONS, VOL. 13, NO. 4, SUPPL S, 2020 VALVE & STRUCTURAL HEART