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Left atrial appendage closure

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https://www.readbyqxmd.com/read/29325636/left-atrial-appendage-closure-and-systemic-homeostasis-the-laa-homeostasis-study
#1
Dhanunjaya Lakkireddy, Mohit Turagam, Muhammad Rizwan Afzal, Johnson Rajasingh, Donita Atkins, Buddhadeb Dawn, Luigi Di Biase, Krzysztof Bartus, Saibal Kar, Andrea Natale, David J Holmes
BACKGROUND: The impact of left atrial appendage (LAA) exclusion, comparing an epicardial LAA or an endocardial LAA device, on systemic homeostasis remains unknown. OBJECTIVES: This study compared the effects of epicardial or endocardial LAA devices on the neurohormonal profiles of patients, emphasizing the roles of the renin-angiotensin-aldosterone system and the autonomic nervous system. METHODS: This is a prospective, single-center, observational study including 77 patients who underwent LAA closure by an epicardial (n = 38) or endocardial (n = 39) device...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29304951/left-atrial-appendage-angiography-is-associated-with-the-incidence-and-number-of-magnetic-resonance-imaging-detected-brain-lesions-after-percutaneous-catheter-based-left-atrial-appendage-closure
#2
Andreas Rillig, Barbara Bellmann, Carsten Skurk, David Manuel Leistner, Karl Georg Haeusler, Tina Lin, Rohat Geran, Luzie Koehler, Selma Guttmann, Daniel Steffens, Mario Kasner, Philipp Jakob, Verena Tscholl, Mattias Roser, Klaus Lenz, Kersten Villringer, Jai-Wun Park, Jochen B Fiebach, Ulf Landmesser
BACKGROUND: Percutaneous catheter-based left atrial appendage closure (LAAC) is a procedure being increasingly performed in patients with atrial fibrillation and high bleeding risk. OBJECTIVE: The purpose of this study was to evaluate the incidence of magnetic resonance imaging (MRI)-detected acute brain lesions (ABLs) as well as potential changes in neurocognitive function after percutaneous LAAC in patients with atrial fibrillation. METHODS: Brain MRI at 3 T was performed within 24 hours before and after LAAC along with neurologic (National Institutes of Health Stroke Scale [NIHSS] score) and cognitive (Montreal Cognitive Assessment [MoCA] test) assessment...
January 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#3
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29250272/percutaneous-left-atrial-appendage-closure-is-there-a-role-in-valvular-atrial-fibrillation
#4
REVIEW
Chetan Huded, Amar Krishnaswamy, Samir Kapadia
Atrial fibrillation, a chronic and highly morbid cardiovascular condition which affects over 33 million people worldwide, can be broadly categorized as valvular vs non-valvular in etiology. However, definitions of valvular atrial fibrillation have varied widely in the literature, and there is no clear consensus definition to date. Historically, patients with atrial fibrillation in the setting of rheumatic mitral valve disease have constituted a particularly high risk group for cardioembolic stroke, and for this reason many contemporary trials of pharmaceutical and device therapies for atrial fibrillation have systematically excluded patients with valvular heart disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250246/leaks-after-left-atrial-appendage-ligation-with-lariat-device-incidence-pathophysiology-clinical-implications-and-methods-of-closure-a-case-based-discussion
#5
Bharath Yarlagadda, Valay Parikh, Tawseef Dar, Dhanunjaya Lakkireddy
Catheter based left atrial appendage (LAA) closure techniques are emerging as a promising alternative for stroke prevention in patients who cannot tolerate oral anticoagulation. Lariat procedure involves percutaneous catheter based epicardial ligation of the LAA with a suture via an endo-epicardial hybrid approach. It offers the advantage of not leaving behind a focus for thrombus formation or embolization. Similar to surgical ligation of the left atrial appendage, Lariat ligation is limited by leaks in a small percentage of patients...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29233088/left-atrial-enlargement-and-clinical-considerations-in-patients-with-or-without-a-residual-interatrial-shunt-after-closure-of-the-left-atrial-appendage-with-the-watchman%C3%A2-device
#6
Blerim Luani, Thomas Groscheck, Conrad Genz, Ivan Tanev, Thomas Rauwolf, Joerg Herold, Senad Medunjanin, Alexander Schmeisser, Rüdiger C Braun-Dullaeus
BACKGROUND: Interventional closure of the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation, high thromboembolic and bleeding risk or bleeding history is an alternative therapeutic strategy to oral anticoagulation. It is not known if the exclusion of the LAA from the blood circulation affects the left atrial volume (LAV) and consequently its prognostic value or the circulatory performance of the heart in humans. METHODS: We aimed to prospectively assess potential changes in baseline LAV, left ventricular ejection fraction (LVEF), NT-proBNP-level and the covered distance in the 6-min walk-test 6 weeks and 6 months after LAA closure with the WATCHMAN™ device...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29222738/ct-based-3d-printing-is-superior-to-transesophageal-echocardiography-for-pre-procedure-planning-in-left-atrial-appendage-device-closure
#7
Edinrin Obasare, Sumeet K Mainigi, D Lynn Morris, Leandro Slipczuk, Igor Goykhman, Evan Friend, Mary Rodriguez Ziccardi, Gregg S Pressman
Accurate assessment of the left atrial appendage (LAA) is important for pre-procedure planning when utilizing device closure for stroke reduction. Sizing is traditionally done with transesophageal echocardiography (TEE) but this is not always precise. Three-dimensional (3D) printing of the LAA may be more accurate. 24 patients underwent Watchman device (WD) implantation (71 ± 11 years, 42% female). All had complete 2-dimensional TEE. Fourteen also had cardiac computed tomography (CCT) with 3D printing to produce a latex model of the LAA for pre-procedure planning...
December 8, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29197455/percutaneous-left-atrial-appendage-closure-versus-oral-anticoagulant-a-bird-in-the-hand-is-worth-two-in-the-bush
#8
EDITORIAL
Rong Bai
No abstract text is available yet for this article.
January 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29197454/left-atrial-appendage-closure-six-reasons-why-i-wouldn-t-choose-a-percutaneous-closure-for-my-appendage
#9
Marco Ferlini, Roberta Rossini
Left atrial appendage has been shown as a primary source of thrombi in patients with non-valvular atrial fibrillation (AF). Non vitamin k oral anticoagulants (NOAC) have been shown to be safe and effective in the prevention of embolic complications. Current guidelines on AF state that percutaneous left atrial appendage closure (LAAC) might be considered in patients with contraindication to long term oral anticoagulant therapy (OAC). An overview of the main trials on NOAC and LAAC is provided.
January 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29194654/safety-and-efficacy-analysis-of-one-stop-intervention-for-treating-nonvalvular-atrial-fibrillation
#10
Hongde Hu, Kaijun Cui, Jian Jiang, Hua Fu, Rui Zeng
BACKGROUND: Nonvalvular atrial fibrillation (AF) is a common arrhythmia. The treatment strategy for AF mainly includes controlling symptoms and decreasing the rate of complications. Our study aimed to evaluate the safety and efficacy of combination treatment of catheter ablation and left atrial appendage (LAA) closure (one-stop intervention) in patients with nonvalvular AF. METHODS AND RESULTS: Thirty-four patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
November 30, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29166715/-left-atrial-appendage-closure-for-stroke-prevention-controversies-and-considerations
#11
Q H Yu, S L Zhang
No abstract text is available yet for this article.
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29160390/left-atrial-appendage-closure-with-amplatzer-cardiac-plug-in-nonvalvular-atrial-fibrillation-safety-and-long-term-outcome
#12
Marcio José Montenegro da Costa, Esmeralci Ferreira, Edgard Freitas Quintella, Bernardo Amorim, Alexandre Fuchs, Ricardo Zajdenverg, Hugo Sabino, Denilson Campos de Albuquerque
BACKGROUND: Atrial fibrillation (AF) is a cardiac arrhythmia with high risk for thromboembolic events, specially stroke. OBJECTIVE: To assess the safety of left atrial appendage closure (LAAC) with the Amplatzer Cardiac Plug for the prevention of thromboembolic events in patients with nonvalvular AF. METHODS: This study included 15 patients with nonvalvular AF referred for LAAC, 6 older than 75 years (mean age, 69.4 ± 9.3 years; 60% of the male sex)...
November 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#13
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29149516/feasibility-of-percutaneous-left-atrial-appendage-closure-using-a-novel-lambre-occluder-in-patients-with-atrial-fibrillation-initial-results-from-a-prospective-cohort-registry-study
#14
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Takahiko Nagase, Nikolaos Tsianakas, Laura Perrotta, K R Julian Chun
BACKGROUND: The LAmbreۛ occluder is a novel device for percutaneous left atrial appendage closure (LAAC). The presented study aimed to report the initial experience in implantation of the novel LAmbre for LAAC in patients with non-valvular AF. METHODS: We conducted a prospective, observational, cohort registry study to evaluate the feasibility of percutaneous LAAC using the LAmbre occlude. RESULTS: Thirty patients (15 female, mean age 77...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29146668/percutaneous-left-atrial-appendage-closure-current-devices-and-clinical-outcomes
#15
REVIEW
Lluis Asmarats, Josep Rodés-Cabau
Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#16
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#17
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29122135/transseptal-puncture-through-amplatzer-atrial-septal-occluder-for-left-atrial-appendage-closure
#18
Steffen Gloekler, Samera Shakir, Bernhard Meier
No abstract text is available yet for this article.
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29122134/left-atrial-appendage-closure-continuous-progress-with-remaining-challenges
#19
EDITORIAL
Horst Sievert, Stefan Bertog
No abstract text is available yet for this article.
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29122133/percutaneous-left-atrial-appendage-closure-with-the-lambre-device-for-stroke%C3%A2-prevention-in-atrial-fibrillation-a-prospective-multicenter-clinical-study
#20
He Huang, Yu Liu, Yawei Xu, Zulu Wang, Yigang Li, Kejiang Cao, Shu Zhang, Yanzong Yang, Xinchun Yang, Dejia Huang, Bo Yu, Xi Su, Liqun Wu, Congxin Huang
OBJECTIVES: The authors sought to assess the clinical outcomes of left atrial appendage (LAA) closure with the LAmbre closure system in patients with nonvalvular atrial fibrillation (NVAF). BACKGROUND: Over 90% of thrombi are located in the LAA in NVAF patients. METHODS: A prospective, multicenter study was conducted in 153 NVAF patients with CHADS2 score ≥1. RESULTS: The LAA was successfully occluded in 152 patients...
November 13, 2017: JACC. Cardiovascular Interventions
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