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Left atrial appendage closure

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https://www.readbyqxmd.com/read/29784681/use-of-intracardiac-echocardiography-in-interventional-cardiology-working-with-the-anatomy-rather-than-fighting-it
#1
REVIEW
Andres Enriquez, Luis C Saenz, Raphael Rosso, Frank E Silvestry, David Callans, Francis E Marchlinski, Fermin Garcia
The indications for catheter-based structural and electrophysiological procedures have recently expanded to more complex scenarios, in which an accurate definition of the variable individual cardiac anatomy is key to obtain optimal results. Intracardiac echocardiography (ICE) is a unique imaging modality able to provide high-resolution real-time visualization of cardiac structures, continuous monitoring of catheter location within the heart, and early recognition of procedural complications, such as pericardial effusion or thrombus formation...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29781063/anticoagulation-resumption-after-intracerebral-hemorrhage
#2
REVIEW
Yan-Guang Li, Gregory Y H Lip
PURPOSE OF REVIEW: Decision-making on resuming oral anticoagulant (OAC) after intracerebral hemorrhage (ICH) evokes significant debate among clinicians. Such patients have been excluded from randomized clinical trials. This review article provides a comprehensive summary of the evidence on anticoagulation resumption after ICH. RECENT FINDINGS: OAC resumption does not increase the risk of recurrent ICH and can also reduce the risk of all-cause mortality. OAC cessation exposes patients to a significantly higher risk of thromboembolism, which could be reduced by resumption...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29779641/don-t-change-the-guidelines-yet-randomized-data-on-surgical-left-atrial-appendage-closure-is-on-the-horizon
#3
EDITORIAL
John J Squiers, J Michael DiMaio
No abstract text is available yet for this article.
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778732/percutaneous-closure-of-peridevice-leak-after-left-atrial-appendage-occlusion
#4
Mohamad Alkhouli, Fahad Alqahtani, Brian Kazienko, Kassandra Olgers, Partho P Sengupta
No abstract text is available yet for this article.
May 11, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29760285/occurrence-of-incomplete-endothelialization-causing-residual-permeability-after-left-atrial-appendage-closure
#5
Mathieu Granier, Guillaume Laugaudin, François Massin, Stephane Cade, Pierre François Winum, Cornelia Freitag, Jean-Luc Pasquie
AIMS: Percutaneous left atrial appendage (LAA) occlusion is occasionally incomplete, with residual permeability of the LAA on cardiac computed tomography. The cause for this is unclear. Our objective was to determine if residual permeability was related to incomplete endothelialization. METHODS: A total of 35 consecutive patients contraindicated for anticoagulant therapy admitted for LAA occlusion were included; 12 patients received a Watchman device (Boston Scientific) and 23 patients received an Amplatzer Cardiac Plug (St...
May 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29759670/systemic-octreotide-therapy-in-prevention-of-gastrointestinal-bleeds-related-to-arteriovenous-malformations-and-obscure-etiology-in-atrial-fibrillation
#6
Venkat Vuddanda, Mohammad-Ali Jazayeri, Mohit K Turagam, Madhav Lavu, Valay Parikh, Donita Atkins, Sudharani Bommana, Madhu Reddy Yeruva, Luigi Di Biase, Jie Cheng, Vijay Swarup, Rakesh Gopinathannair, Mojtaba Olyaee, Vijay Ivaturi, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The present study describes the use of octreotide (OCT) in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) who have gastrointestinal (GI) bleeding related to arteriovenous malformations (AVMs), as well as its effect on OAC tolerance and subsequent rebleeding. BACKGROUND: AVMs cause significant GI bleeding, especially in patients with AF who are receiving OAC for stroke prevention. OCT has been shown to minimize recurrent GI bleeds related to AVMs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759664/angiographic-efficacy-of-the-atriclip-left-atrial-appendage-exclusion-device-placed-by-minimally-invasive-thoracoscopic-approach
#7
Christopher R Ellis, Sam G Aznaurov, Neel J Patel, Jennifer R Williams, Kim Lori Sandler, Steven J Hoff, Stephen K Ball, S Patrick Whalen, John Jeffrey Carr
OBJECTIVES: This study sought to assess long-term left atrial appendage (LAA) closure efficacy of the Atriclip applied via totally thoracoscopic (TT) approach with computed tomographic angiography. BACKGROUND: LAA closure is associated with a low risk for atrial fibrillation-related embolic stroke. The Atriclip exclusion device allows epicardial LAA closure, avoiding the need for post-operative oral anticoagulation. Previous data with Atriclip during open chest procedures show a high efficacy rate of closure >95%...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754931/percutaneous-left-atrial-appendage-closure-with-complex-anatomy-by-using-the-staged-kissing-watchman-technology-with-double-devices
#8
Lisheng Jiang, Erich Duenninger, Manuela Muenzel, Xin Xue, Adam Fazakas, Thorsten Keil, Jiangtao Yu
BACKGROUND: Left atrial appendage closure (LAAC) is an efficient alternative of oral anticoagulation to prevent stroke in patients with non-valvular atrial fibrillation (NVAF). Due to complexities of LAA anatomy, a complete closure may not always be obtained with a single device. The aim of this study was to evaluate the feasibility and safety of the staged 'kissing-Watchman' technology to occlude the LAA with complex anatomy. METHODS: In our center, among 300 cases underwent LAAC with Watchman device from February 2012 to December 2016, 7 complex LAAs were implanted double devices using the staged 'kissing-Watchman' technology...
May 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29754808/long-term-event-reduction-after-left-atrial-appendage-closure-results-of-the-iberian-registry-ii
#9
José R López-Mínguez, Juan M Nogales-Asensio, Eduardo Infante De Oliveira, Vasco De Gama Ribeiro, Rafael Ruiz-Salmerón, Dabit Arzamendi-Aizpurua, Marco Costa, Hipólito Gutiérrez-García, José Antonio Fernández-Díaz, Victoria Martín-Yuste, Juan Carlos Rama-Merchán, Raúl Moreno-Gómez, Amparo Benedicto-Buendía, Andrés Íñiguez-Romo
INTRODUCTION AND OBJECTIVES: Many patients with nonvalvular atrial fibrillation are still left without protection due to a contraindication for anticoagulants. This study aimed to establish the occurrence of stroke and major bleeding events in patients with nonvalvular atrial fibrillation and left atrial appendage closure with long-term follow-up and to explore the factors associated with higher long-term mortality. METHODS: Analysis of a multicenter single cohort prospectively recruited from 2009 to 2015...
May 10, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29752398/device-related-thrombus-after-left-atrial-appendage-closure-incidence-predictors-and-outcomes
#10
Srinivas R Dukkipati, Saibal Kar, David R Holmes, Shephal K Doshi, Vijendra Swarup, Douglas N Gibson, Brijeshwar Maini, Nicole T Gordon, Michael L Main, Vivek Y Reddy
Background -In patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) with the Watchman device prevents thromboembolism from the LAA; however, thrombus may form on the left atrial face of the device, and then potentially embolize. Herein, we studied the incidence, predictors and clinical outcome of device-related thrombus (DRT) using a large series of clinical trial cohorts of patients undergoing Watchman implantation. Methods -We studied the device arms of 4 prospective FDA trials: PROTECT-AF (n=463); PREVAIL (n=269); CAP (n=566); CAP2 (n=578)...
May 11, 2018: Circulation
https://www.readbyqxmd.com/read/29746708/left-atrial-thrombus-two-years-after-placement-of-a-left-atrial-appendage-closure-device
#11
David H Yoo, Brian Clark, Daniel Nguyen, Timm-Michael Dickfeld, Andrew S Zohlman, Libin Wang, Vincent Y See
A 72-year-old man who underwent a left atrial appendage (LAA) closure device two years ago, presented with atrial flutter with rapid ventricular rate and was referred for cardioversion. Pre-cardioversion transesophageal echocardiogram (TEE) showed left atrial thrombus and therefore the procedure was aborted. Currently, there is no guideline on imaging surveillance or anticoagulation in patients with LAA closure device who develop intracardiac thrombus after the initial six month surveillance period. This article is protected by copyright...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29743994/approaches-to-left-atrial-appendage-closure-device-design-performance-and-limitations
#12
REVIEW
Amish S Dave, Miguel Valderrábano
Up to 6.1 million people in the United States have atrial fibrillation (AF), which is associated with an increased risk of stroke. Oral anticoagulants are the mainstay of stroke prevention in AF. For decades, warfarin was the only available drug, fraught with compliance limitations, a narrow therapeutic window, and a high risk of hemorrhage. Pharmacologic developments have produced new anticoagulants that have improved the rates of stroke related to AF; however, they still confer a high risk of bleeding, making them unsuitable for some patients...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29739915/cost-effectiveness-of-left-atrial-appendage-closure-with-the-watchman-device-compared-with-warfarin-or-non-vitamin-k-antagonist-oral-anticoagulants-for-secondary-prevention-in-nonvalvular-atrial-fibrillation
#13
Vivek Y Reddy, Ronald L Akehurst, Stacey L Amorosi, Meghan B Gavaghan, Deanna S Hertz, David R Holmes
BACKGROUND AND PURPOSE: Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non-vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29737618/long-term-follow-up-of-3-t-mri-detected-brain-lesions-after-percutaneous-catheter-based-left-atrial-appendage-closure
#14
Barbara Bellmann, Andreas Rillig, Carsten Skurk, David Manuel Leistner, Karl Georg Haeusler, Tina Lin, Rohat Geran, Luzie Koehler, Selma Guttmann, Verena Tscholl, Mattias Roser, Klaus Lenz, Kersten Villringer, Jai- Wun Park, Jochen B Fiebach, Ulf Landmesser
BACKGROUND: Left atrial appendage closure (LAAC) for stroke prevention is an increasingly performed intervention. AIMS: This prospective study aims to evaluate the incidence of long-term magnetic resonance imaging (MRI)-detected brain lesions as well as potential changes of neurocognitive function after percutaneous LAAC. METHODS: Brain MRI at 3 T was performed within 24 hr before and after LAAC. A follow-up MRI was carried out after three months...
May 8, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29727507/optimal-combination-strategy-of-left-atrial-appendage-closure-plus-catheter-ablation-in-a-single-procedure-in-patients-with-nonvalvular-atrial-fibrillation
#15
Xianfeng Du, Huimin Chu, Bin He, Binhao Wang, Jing Liu, Mingjun Feng, Yibo Yu, Guohua Fu, He Jin, Fang Gao, Jingjing Zhu, Xiaomin Chen
BACKGROUND: The efficacy and safety of combining left atrial appendage closure (LAAC) plus atrial fibrillation (AF) catheter ablation (CA) in a single procedure has been established, but the optimal combination strategy has not been thoroughly elucidated to date. OBJECTIVE: We aimed to investigate the impact of different combination strategies on clinical outcomes. METHODS: Eighty-two consecutive patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
May 4, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29722469/incidence-of-pericardial-effusion-after-left-atrial-appendage-closure-the-impact-of-underlying-heart-rhythm-data-from-the-ewolution-study
#16
Boris Schmidt, Timothy R Betts, Horst Sievert, Martin W Bergmann, Stephan Kische, Evgeny Pokushalov, Thomas Schmitz, Felix Meincke, Patrizio Mazzone, Kenneth M Stein, Hüseyin Ince, Lucas V A Boersma
INTRODUCTION: Pericardial effusion/tamponade (PE/PT) is a rare but serious complication following left atrial appendage closure (LAAC). It may be speculated that LAA contraction during sinus rhythm (SR) exerts mechanical force on the device that eventually leads to PE. We sought to determine the incidence and predictors of PE following LAAC using Watchman with special emphasis on the underlying heart rhythm during implant. METHODS AND RESULTS: From 47 centers in 13 European countries 1020 patients underwent LAAC and data on baseline rhythm were available from 1010 patients (mean age 73 ± 9 years, 60% male, median CHA2DS2-VASc = 4)...
May 3, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29719981/surgical-perspective-of-percutaneous-device-closure-of-atrial-septal-defect
#17
Shyam Kumar Singh Thingnam, Sachin Mahajan, Vikas Kumar
Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29718897/optimal-nonvitamin-k-antagonist-oral-anticoagulant-therapy-in-a-warfarin-sensitive-patient-after-left-atrial-appendage-closure-a-case-report
#18
Long Shen, Sha-Sha Fang, Heng Ge, Zhi-Qing Qiao, Zhi-Chun Gu
RATIONALE: Developing an optimal medication strategy poses a challenging task in fragile patients after left atrial appendage closure (LAAC). We report an optimal nonvitamin K antagonist oral anticoagulant (NOAC) therapy in a warfarin-sensitive patient after LAAC. PATIENT CONCERNS: A 77-year-old nonvalvular atrial fibrillation (NVAF) male carrying 2 warfarin-sensitive alleles experienced 2 gum-bleeding with the international normalized ratio (INR) around 3. DIAGNOSES: Persistent NVAF with a history of subtotal gastrectomy and moderate renal insufficiency...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29718529/impact-of-left-atrial-appendage-closure-on-cardiac-functional-and-structural-remodeling-a-difference-in-difference-analysis-of-propensity-score-matched-samples
#19
Quang Tan Phan, Seung-Yong Shin, Ik-Sung Cho, Wang-Soo Lee, Hoyoun Won, Saima Sharmin, Dong-Young Lee, Tae-Ho Kim, Chee-Jeong Kim, Sang-Wook Kim
BACKGROUND: Although the safety and efficacy of left atrial appendage (LAA) closure (LAAC) in nonvalvular atrial fibrillation (NVAF) patients have been well documented in randomized controlled trials and real-world experience, there are limited data in the literature about the impact of LAAC on cardiac remodeling. The aim of the study was to examine the impact of LAAC on cardiac functional and structural remodeling in NVAF patients. METHOD: s: Between March 2014 and November 2016, 47 NVAF patients who underwent LAAC were included in this study (LAAC group)...
May 2, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29697599/significantly-elevated-c-reactive-protein-levels-after-epicardial-clipping-of-the-left-atrial-appendage
#20
Niels J Verberkmoes, Ferdi Akca, Ann-Sofie Vandevenne, Luuk Jacobs, Mohamed A Soliman Hamad, Albert H M van Straten
OBJECTIVE: Besides mechanical and anatomical changes of the left atrium, epicardial closure of the left atrial appendage has also possible homeostatic effects. The aim of this study was to assess whether epicardial clipping of the left atrial appendage has different biochemical effects compared with complete removal of the left atrial appendage. METHODS: Eighty-two patients were included and underwent a totally thoracoscopic AF ablation procedure. As part of the procedure, the left atrial appendage was excluded with an epicardial clip (n = 57) or the left atrial appendage was fully amputated with an endoscopic vascular stapler (n = 25)...
April 24, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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