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JOURNAL ARTICLE
Dominika Kanschik, Houtan Heidari, Kathrin Klein, Amin Polzin, Verena Veulemans, Jürgen Leick, Malte Kelm, Christian Jung, Tobias Zeus, Shazia Afzal
Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of two interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2)...
February 29, 2024: Journal of Cardiovascular Development and Disease
#22
REVIEW
Khi Yung Fong, Selvie Yeo, Haidong Luo, Theodoros Kofidis, Kristine L K Teoh, Giap Swee Kang
BACKGROUND: Stroke is a much-feared complication of cardiac surgery, but existing literature on preventive strategies is fragmented. Hence, a systematic review and meta-analysis of stroke prevention strategies for cardiac surgery was conducted. METHODS: An electronic literature search was conducted to retrieve randomized controlled trials (RCTs) investigating perioperative interventions for cardiac surgery, with stroke as an outcome. Random-effects meta-analyses were conducted to generate risk ratios (RRs), 95% confidence intervals (95% CI), and forest plots...
March 26, 2024: ANZ Journal of Surgery
#23
Zixi Zhang, Jiabao Zhou, Qiuzhen Lin, Cancan Wang, Yunying Huang, Yongguo Dai, Wanyun Zuo, Na Liu, Yichao Xiao, Qiming Liu
BACKGROUND: Approximately 90% of intracardial thrombi originate from the left atrial appendage in non-valvular atrial fibrillation patients. Even with anticoagulant therapy, left atrial appendage thrombus (LAAT) still occurs in 8% of patients. While left atrial appendage closure (LAAC) could be a promising alternative, the current consensus considers LAAT a contraindication to LAAC. However, the feasibility and safety of LAAC in patients with LAAT have yet to be determined. METHODS: This systematic review synthesizes published data to explore the feasibility and safety of LAAC for patients with LAAT...
March 21, 2024: BMC Cardiovascular Disorders
#24
JOURNAL ARTICLE
Sandeep K Goyal, Ashish A Bhimani, Danesh K Kella, Anahita Tyagi, Venkateshwar Polsani, Thomas F Deering
INTRODUCTION: Percutaneous left atrial appendage occlusion (LAAO) is traditionally performed under general anesthesia with trans-esophageal echocardiography guidance. Intracardiac echo (ICE)-guided LAAO closure is increasing in clinical use. The ICE catheter is crossed into LA via interatrial septum (IAS) after the septum is dilated with LAAO delivery sheath. This step can be time-consuming and requires significant ICE catheter manipulation, which increases the risk of cardiac perforation...
March 21, 2024: Journal of Cardiovascular Electrophysiology
#25
JOURNAL ARTICLE
Yao Yao, Yanli Li, Qinchun Jin, Xiaoye Li, Xiaochun Zhang, Qianzhou Lv
Insufficient data exist regarding the investigation of the impact of novel oral anticoagulants (NOACs) on coagulation activation biomarkers in the context of left atrial appendage closure (LAAC) and device-related thrombosis (DRT). The study was designed to investigate the changes and presence of coagulation activation biomarkers between different antithrombotic strategies following LAAC. A total of 120 nonvalvular atrial fibrillation patients intolerant of long-term anticoagulants, who underwent successful WATCHMAN closure implantation, were enrolled (rivaroxaban, n = 82; dabigatran, n = 38)...
2024: Cardiovascular Therapeutics
#26
REVIEW
Shohei Kataoka, Morio Shoda, Koichiro Ejima, Ken Kato, Kyoichiro Yazaki, Shun Hasegawa, Masayuki Sakai, Satoshi Higuchi, Daigo Yagishita, Junichi Yamaguchi
BACKGROUND AND OBJECTIVE: Treatment for atrial fibrillation (AF) has evolved significantly, with pulmonary vein isolation (PVI) becoming an established treatment. However, the outcomes following catheter ablation for persistent AF remain unsatisfactory. Hybrid catheter-surgical ablation has emerged as a therapeutic approach for persistent AF, combining the strengths of both interventions. The purpose of this narrative review is to comprehensively examine the current state of knowledge regarding hybrid ablation for AF...
February 29, 2024: Journal of Thoracic Disease
#27
JOURNAL ARTICLE
Left atrial appendage occlusion: On the need of a numerical model to simulate the implant procedure.
Francesca Danielli, Francesca Berti, Benigno Marco Fanni, Emanuele Gasparotti, Simona Celi, Giancarlo Pennati, Lorenza Petrini
Left atrial appendage occlusion (LAAO) is a percutaneous procedure to prevent thromboembolism in patients affected by atrial fibrillation. Despite its demonstrated efficacy, the LAA morphological complexity hinders the procedure, resulting in postprocedural drawbacks (device-related thrombus and peri-device leakage). Local anatomical features may cause difficulties in the device's positioning and affect the effectiveness of the device's implant. The current work proposes a detailed FE model of the LAAO useful to investigate implant scenarios and derive clinical indications...
March 19, 2024: International Journal for Numerical Methods in Biomedical Engineering
#28
Thebuoshon Amalathasan, Pooja A Nagaratnam, Mirna El Dirani, Julius M Nagaratnam, Samer Kholoki
Currently, oral anticoagulants are considered the gold standard for stroke prevention in patients with atrial fibrillation. Despite the efficacy of oral anticoagulants in reducing stroke incidence, patients are at risk of developing adverse reactions such as excessive bleeding and bruising, and can also have drug-drug interactions. In the early 2000s, a minimally invasive technique called the left atrial appendage closure emerged as an alternative for stroke prevention in atrial fibrillation patients who could not tolerate oral anticoagulants...
February 2024: Curēus
#29
JOURNAL ARTICLE
Jan Gofus, Pavel Zacek, Youssef Shahin, Karel Medilek, Ludek Haman, Jan Vojacek
Prophylactic left atrial appendage occlusion has been suggested as a means of cardioembolism risk reduction in patients with atrial fibrillation. Its clinical benefits have been discussed together with potential endocrine or hemodynamic adverse effects, providing conflicting resolutions. We aimed to provide a thorough overview of the current literature and a recommendation for daily clinical decision making. A comprehensive Medline search through PubMed was utilized to search for relevant articles, further filtered by the title and abstract...
March 17, 2024: Kardiologia Polska
#30
JOURNAL ARTICLE
Alberto Preda, Davide Margonato, Carlo Gaspardone, Vincenzo Rizza, Ciro Vella, Lorenzo Rampa, Alessandra Marzi, Fabrizio Guarracini, Paolo Della Bella, Eustachio Agricola, Achille Gaspardone, Matteo Montorfano, Patrizio Mazzone
INTRODUCTION: In patients with atrial fibrillation (AF) on vitamin K antagonist (VKA) therapy and therapeutical INR range the incidence of cardiac thromboembolism is not negligible and the subgroup carrying a mechanical prosthetic mitral valve (PMV) has the highest risk. We aimed to assess the long-term effects of left atrial appendage closure (LAAC) in AF patients carriers of mechanical PMV who experienced a failure of VKA therapy. METHODS: In this retrospective, multicenter study, patients underwent LAAC because of thrombotic events including TIA/stroke, systemic embolism and evidence of left atrial appendage thrombosis/sludge despite VKA therapy were enrolled...
March 14, 2024: Canadian Journal of Cardiology
#31
Kifah Hussain, Christopher Ding, Jose Nazari, Mark Metzl, Amit Pursnani, Jonathan R Rosenberg
No abstract text is available yet for this article.
March 2024: Structural heart: the journal of the Heart Team
#32
JOURNAL ARTICLE
Marco Frazzetto, Claudio Sanfilippo, Matteo Pelliccia, Corrado Tamburino, Carmelo Grasso
No abstract text is available yet for this article.
March 1, 2024: Journal of Cardiovascular Medicine
#33
JOURNAL ARTICLE
Ahmet Hakan Ates, Ahmet Kivrak, Ugur Nadir Karakulak, Cem Coteli, Hikmet Yorgun, Mehmet Levent Sahiner, Ergun Barıs Kaya, Kudret Aytemir
BACKGROUND: The study explores left atrial appendage closure (LAAC) as a safe and effective alternative to anticoagulation for atrial fibrillation (AF) patients at high bleeding risk. Complications, such as cardioembolic events due to left atrial appendage thrombus (LAAT), highlight the need for alternative stroke prevention strategies. AIMS: This research assesses LAAC's safety and efficacy in patients with LAAT, aiming to offer valuable insights into its potential as a viable option for stroke prevention in such cases...
March 13, 2024: Pacing and Clinical Electrophysiology: PACE
#34
Xiaohua Liu, Yizhou Xu
INTRODUCTION: Left atrial appendage (LAA) closure (LAAC) is considered a viable alternative to anticoagulation therapy for stroke prevention in nonvalvular atrial fibrillation, we report a case with a less common shunt resulting from a device-related coronary artery-appendage fistula (CAAF) following LAAC. METHODS AND RESULTS: A 67-year-old male with a history of LAAC was referred to our emergency room with recurrent chest pain and palpitations and was diagnosed with ischemic angina pectoris...
March 11, 2024: Journal of Cardiovascular Electrophysiology
#35
JOURNAL ARTICLE
Hidetomi Takahashi, Akihiro Yoshimoto, Yoshiki Yamasaki, Kanan Kurahashi, Takafumi Inoue, Yoshihiro Suematsu
Oral anticoagulants for atrial fibrillation are the standard approach to prevent stroke in patients with atrial fibrillation. However, oral anticoagulant therapy carries the risk of cerebral infarction recurrence, not to mention hemorrhagic complications, even under appropriate drug therapy. Surgical treatments targeting the left atrial appendage include left atrial appendage closure( LAAO) and left atrial appendage resection (LAAR). Our hospital uses AtriClip (approved and available in Japan since 2018) as a device for LAAO, and we investigated the early and long-term results of LAAO using AtriClip in our hospital...
January 2024: Kyobu Geka. the Japanese Journal of Thoracic Surgery
#36
REVIEW
Eiichi Ohba, Yoshinori Kuroda, Masahiro Mizumoto, Ai Ishizawa, Daisuke Watanabe, Shingo Nakai, Kimihiro Kobayashi, Tetsuro Uchida
BACKGROUND: Occlusion of the left atrial appendage( LAA) may prevent stroke in patients with atrial fibrillation. In this study, we reviewed various types of LAA occlusion techniques and results of patients underwent surgical LAA closure. METHODS: Between 2004 and 2022, 182 patients who underwent surgical LAA closure were enrolled in this study. RESULTS: The surgical LAA closure consisted of 90 cases of closure device, AtriCure, 63 cases of surgical excision, 13 cases of stapler excision, 3 cases of ligation, and 13 cases of internal suture ligation...
January 2024: Kyobu Geka. the Japanese Journal of Thoracic Surgery
#37
JOURNAL ARTICLE
Vivian Vij, Tobias Friedrich Ruf, Jean-Benoit Thambo, Lara Vogt, Saddam M A Al-Sabri, Dominik Nelles, Jan-Wilko Schrickel, Thomas Beiert, Georg Nickenig, Ralph Stephan von Bardeleben, Xavier Iriart, Alexander Sedaghat
BACKGROUND: Advances in imaging have led to procedural optimization of left atrial appendage closure (LAAC). Contrast-free approaches, guided merely by echocardiography, have been established, however data on this topic remains scarce. In this analysis, we assessed contrast-free procedural results with the LAMBRE LAAC device. METHODS: The multicenter retrospective BoBoMa (Bonn/Bordeaux/Mainz)-Registry included a total of 118 patients that underwent LAAC with LAMBRE devices omitting contrast-dye...
March 6, 2024: International Journal of Cardiology
#38
JOURNAL ARTICLE
Yang-Qi Pan, Lu-Shen Jin, Sang Qian, Ting Jiang, Zhe-Ning Wang, Yi-Lian Chen, Yi-Xuan Qiu, Yi-Hao Wu, Jia-Yang Fu, Ling Li, Yuan-Nan Lin, Yue-Chun Li
Background and aim: Rivaroxaban is an emerging oral anticoagulant for postoperative anticoagulation after percutaneous left atrial appendage closure (LAAC). Because a once-daily dosing regimen of rivaroxaban causes fluctuations in the drug plasma concentration, we studied the feasibility and safety of twice-daily rivaroxaban as a postoperative anticoagulation regimen for patients with atrial fibrillation (AF) undergoing LAAC. Methods: This study involved patients with AF who underwent LAAC and took rivaroxaban postoperatively...
2024: Frontiers in Pharmacology
#39
JOURNAL ARTICLE
Sophie Eppinger, Kerstin Piayda, Roberto Galea, Marcus Sandri, Moniek Maarse, Ahmet Güner, Can Y Karabay, Ashish Pershad, Wern Y Ding, Adel Aminian, Ibrahim Akin, Karapet V Davtyan, Ivan A Chugunov, Eloi Marijon, Liesbeth Rosseel, Thomas Robert Schmidt, Nicolas Amabile, Kasper Korsholm, Juha Lund, Enio Guerios, Ignacio J Amat-Santos, Giacomo Boccuzzi, Christopher R Ellis, Avi Sabbag, Henning Ebelt, Brian Clapp, Hana Vaknin Assa, Amos Levi, Jakob Ledwoch, Sonja Lehmann, Oh-Hyun Lee, George Mark, Wendy Schell, Domenico G Della Rocca, Andrea Natale, Ole de Backer, Joelle Kefer, Pablo P Esteban, Mark Abelson, Pradhum Ram, Pamela Moceri, Jose G Galache Osuna, Xavier Millán Alvarez, Ignacio Cruz-Gonzalez, Tom de Potter, Moubarak Ghassan, Andrey Osadchiy, Weita Chen, Sandeep K Goyal, Francesco Giannini, Máximo Rivero-Ayerza, Shazia Afzal, Christian Jung, Carsten Skurk, Martin Langel, Mark Spence, Evgeny Merkulov, Mathieu Lempereur, Seung Y Shin, Jules Mesnier, Heather L McKinney, Brian T Schuler, Sebastien Armero, Livia Gheorghe, Marco B M Ancona, Lino Santos, Jacques Mansourati, Luis Nombela-Franco, Francesco Nappi, Michael Kühne, Achille Gaspardone, Jesper van der Pals, Matteo Montorfano, Juan Fernández-Armenta, James E Harvey, Josep Rodés-Cabau, Norbert Klein, Sajjad A Sabir, Jung-Sun Kim, Stephane Cook, Ran Kornowski, Antti Saraste, Jens E Nielsen-Kudsk, Dhiraj Gupta, Lucas Boersma, Lorenz Räber, Kolja Sievert, Horst Sievert, Stefan Bertog
BACKGROUND: Left atrial appendage (LAA) occluder embolization is an infrequent but serious complication. OBJECTIVES: We aim to describe timing, management and clinical outcomes of device embolization in a multi-center registry. METHODS: Patient characteristics, imaging findings and procedure and follow-up data were collected retrospectively. Device embolizations were categorized according to 1) timing 2) management and 3) clinical outcomes...
February 28, 2024: Cardiovascular Revascularization Medicine: Including Molecular Interventions
#40
Tiago Vasconcelos, Fábio Caleça Emidio, Frederico Silva, Joana Nascimento, Marta Duarte
The management of anticoagulation in patients with ischemic stroke and atrial fibrillation (AF) poses a critical dilemma due to the inherent risk of hemorrhagic transformation. This article presents the case of an 89-year-old male with AF and recurrent ischemic strokes, highlighting the complex challenge of deciding whether to initiate or withhold anticoagulation. After the initial ischemic stroke event, the patient started a direct oral anticoagulant. Subsequent imaging revealed hemorrhagic transformation, leading to the cessation of anticoagulation...
February 2024: Curēus
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