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Young Woong Kim, Ho Jin Kim, Min Ho Ju, Jae Won Lee
Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA)...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Sarah Page, Jane Hallam, Neelprada Pradhan, Brian Cowie, Tuong Phan, Desmond McGlade, Alex Rosalion, Andrew Newcomb, Michael Yii
BACKGROUND: Atrial fibrillation (AF) affects 1.5-2% of the population and is associated with a five-fold increased lifetime risk of stroke [1]. The left atrial appendage (LAA) is the source of embolic strokes in up to 90% of patients with non-valvular AF with clots in the left atrium [2]. METHODS: We reviewed the clinical notes and echocardiographic findings of 20 patients who underwent open cardiac surgery in which concurrent AtriClip (Atricure Inc, Westchester, Ohio, USA) device insertion was attempted at our institution from July 2013 to February 2015...
December 22, 2017: Heart, Lung & Circulation
Kinjal M Patel, Michael Rosenbloom, Muhammad Raza, Sean Stevens, Jonathan Rost, Ahmed Awad, Ronak G Desai
We report the unexpected transesophageal echocardiography (TEE) finding of a left atrial (LA) thrombus near the end of cardiopulmonary bypass and after deployment of an AtriClip (Atricure, Inc, Westchester, OH) in an 84-year-old man with atrial fibrillation and aortic stenosis undergoing aortic valve replacement and LA appendage ligation. TEE examination before cardiopulmonary bypass and deployment of the AtriClip had not shown a thrombus in the LA appendage. The heart was rearrested and thrombus was successfully removed through a left atriotomy...
September 20, 2017: A & A Case Reports
F Akca, N J Verberkmoes, S E Verstraeten, C van Laar, B P van Putte, A H M van Straten
INTRODUCTION: Left atrial appendage (LAA) closure has become of major interest for patients with atrial fibrillation intolerant to oral anticoagulation therapy (OAC). Patients with a contraindication to both OAC and antiplatelet therapy are not eligible for percutaneous LAA closure. We aimed to find an alternative treatment for these specific patients. METHODS: From March 2014 until December 2015 five patients were referred for percutaneous LAA closure. Alternative treatment was necessary due to an absolute contraindication to OAC and antiplatelet therapy (n = 4) or after previous failed percutaneous device implantation (n = 1)...
September 2017: Netherlands Heart Journal
Thomas Schroeter, Martin Misfeld
Atrial fibrillation has a significant impact on patient mortality and morbidity. In particular, stroke is a frequent complication associated with atrial fibrillation. In recent years, various treatment options have been developed that are based on the elimination of atypical electrically active atrial areas. Areas covered: This manuscript presents a new cryoablation probe from AtriCure Inc. In addition to describing the characteristics of the probe, we also discuss atrial fibrillation and its surgical therapy options as well as the basics of cryosurgery...
April 2017: Expert Review of Medical Devices
Aleš Mokráček, Vojtěch Kurfirst, Alan Bulava, Jiří Haniš
INTRODUCTION: Atrial fibrillation (AFib) is related to a high risk of stroke. The main role in etiopathogenesis is played by the left atrial appendage (LAA). As many as 95 % of thrombi in nonvalvular atrial fibrillation are located in the appendage. Prevention of stroke then consists in permanent anticoagulation which, however, has its limits and risks. An alternative method is the left atrial appendage occlusion. In our report, we would like to present a new possibility of the closure using the epicardial system AtriClip (AtriCure)...
December 0: Vnitr̆ní Lékar̆ství
Ashraf Alqaqa, Shabiah Martin, Aiman Hamdan, Fayez Shamoon, Kourosh T Asgarian
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
Motoyuki Kumagai, Junichiro Nishizawa, Daisuke Heima, Kazuhiro Takatoku, Yoshihiko Watanabe, Yasuzumi Matsui, Hidenori Miyake
A 67-year-old woman suffered from severe aortic stenosis and atrial fibrillation, and underwent aortic valve replacement with a St. Jude Medical Regent 23-mm valve and pulmonary vein isolation using an AtriCure Isolator Synergy.At 6 days after the operation, she experienced sudden onset of atrial fibrillation, left side paralysis, and dysarthria. Right internal carotid artery embolism was diagnosed via magnetic resonance imaging, and we promptly performed neuroendovascular therapy with a Solitaire FR. Neuroendovascular treatment succeeded, and her neurological function was restored to near-normal...
December 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jonathan M Philpott, Christian W Zemlin, James L Cox, Mack Stirling, Michael Mack, Robert L Hooker, Allen Morris, David A Heimansohn, James Longoria, Divyakant B Gandhi, Patrick M McCarthy
BACKGROUND: The Cox Maze-IV procedure (CMP-IV) has replaced the Cox Maze-III procedure as the most common approach for the surgical treatment of atrial fibrillation (AF). The Food and Drug Administration-regulated AtriCure Bipolar Radiofrequency Ablation of Permanent Atrial Fibrillation (ABLATE) trial sought to demonstrate the safety and efficacy of the CMP-IV performed with the Synergy ablation system (AtriCure, Inc, Cincinnati, OH). METHODS: Fifty-five patients (aged 70...
November 2015: Annals of Thoracic Surgery
Julia Goette, Timo Weimar, Martina Vosseler, Michael Raab, Ulrike Walle, Markus Czesla, Nicolas Doll
Background Recent guidelines have recommended the addition of ablation in cardiac surgery for patients presenting with atrial fibrillation (AF). Currently available cryoablation devices use either nitrous oxide or argon gas as cooling agent. Our study aimed to compare success rates of two different devices currently available on the market and applied during concomitant cardiac surgery. Methods Between 2009 and 2012, data were collected from 120 consecutive patients in whom either the aluminum cryoICE ablation probe (AtriCure, Inc...
December 2016: Thoracic and Cardiovascular Surgeon
Basel Ramlawi, Walid K Abu Saleh, James Edgerton
A patient with atrial fibrillation (AF) has a greater than 5% annual risk of major stroke, a 5-fold increase compared to the general population. While anticoagulation remains the standard stroke prevention strategy, the nature of lifelong anticoagulation inevitably carries an increased risk of bleeding, increased stroke during periods of interruption, increased cost, and significant lifestyle modification. Many patients with atrial fibrillation have had their left atrial appendage (LAA) ligated or excised by surgeons during cardiac surgery, a decision based largely on intuition and with no clear evidence of efficacy in stroke risk reduction...
April 2015: Methodist DeBakey Cardiovascular Journal
Yan Li, Qiu-Ming Hu, Chun-Lei Xu, Wen Zeng, Yi-Xin Jia, Xu Meng
OBJECTIVE: To evaluate the safety and feasibility of a completely thoracoscopic modified Maze procedure for treatment of patients with lone atrial fibrillation(AF). METHODS: From September 2010 to October 2011, completely thoracoscopic modified Maze procedure was performed in 23 patients with lone atrial fibrillation (14 paroxysmal AF and 9 persistent AF). All patients were either refractory or intolerant to antiarrhythmic drug therapy or already experienced unsuccessful catheter-based ablation...
August 2013: Zhonghua Xin Xue Guan Bing za Zhi
Rochus K Voeller, Andreas Zierer, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: : Over recent years, a variety of energy sources, including bipolar radiofrequency, have been used to replace the traditional incisions of the Cox-Maze procedure for the surgical treatment of atrial fibrillation (AF). The purpose of this study was to evaluate the safety and efficacy of a novel dual-electrode bipolar radiofrequency ablation device Synergy (Atricure, Inc., Cincinnati, OH USA) for AF in a chronic porcine model. METHODS: : Six domestic pigs underwent a modified Cox-Maze IV procedure without cardiopulmonary bypass using the Synergy device...
January 2011: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Spencer J Melby, Andreas Zierer, Rochus K Voeller, Shelly C Lall, Marci S Bailey, Marc R Moon, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: : Bipolar radiofrequency ablation recently has been used to replace many of the incisions of the Cox-Maze procedure in the surgical treatment of atrial fibrillation. The unique aspect of this technology is that it uses an algorithm based on changes in tissue conductance to determine the energy required to achieve a transmural lesion instead of relying on predetermined time and/or temperature criteria to determine ablation duration, as with most other ablation technologies. The purpose of this study was to determine variations in the different parameters of ablation needed to create transmural lesions in human atria...
March 2007: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Anson M Lee, Abdulhameed Aziz, Kal L Clark, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: The creation of consistently transmural lesions with epicardial ablation on the beating heart has represented a significant challenge for current technology. This study examined the chronic performance of the AtriCure Coolrail device (AtriCure Inc, West Chester, Ohio), an internally cooled, bipolar radiofrequency ablation device designed for off-pump epicardial ablation. The study also examined the reliability of using acute intraoperative conduction delay to evaluate lesion integrity...
October 2012: Journal of Thoracic and Cardiovascular Surgery
Gorav Ailawadi, Marc W Gerdisch, Richard L Harvey, Robert L Hooker, Ralph J Damiano, Thomas Salamon, Michael J Mack
OBJECTIVE: Up to 90% of embolic strokes that occur in patients with atrial fibrillation originate from the left atrial appendage. Exclusion of the left atrial appendage during cardiac surgery may decrease the future risk of stroke, especially in patients with atrial fibrillation or at high risk for developing atrial fibrillation. We report the initial results of a multicenter Food and Drug Administration trial to assess the safety and efficacy of a novel left atrial appendage exclusion clip...
November 2011: Journal of Thoracic and Cardiovascular Surgery
Pei-sheng Liu, Xin Chen, Ming Liu
OBJECTIVE: To analyze the transmural lesions of different parts of the pig heart atrium received different times of ablation applied with Atricure bipolar radiofrequency system. METHODS: Six fresh (ex vivo time<20 min) pig hearts with atrium preserved intact were used as the experimental objects and experimental groups were divided according to the ablation position. The Atricure bipolar radiofrequency system was applied in the ablation of the parts of the atrium, such as posterior wall of left atrium, anterior wall of left atrium, anterior wall of right atrium and posterior wall of left atrium close to mitral posterior ring...
December 15, 2010: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Rochus K Voeller, Andreas Zierer, Shelly C Lall, Shun-ichiro Sakamoto, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: Over recent years, a variety of energy sources have been used to replace the traditional incisions of the Cox maze procedure for the surgical treatment of atrial fibrillation. This study evaluated the safety and efficacy of a new bipolar radiofrequency ablation device for atrial ablation in a long-term porcine model. METHODS: Six pigs underwent a Cox maze IV procedure on a beating heart off cardiopulmonary bypass using the AtriCure Isolator II bipolar ablation device (AtriCure, Inc, Cincinnati, Ohio)...
July 2010: Journal of Thoracic and Cardiovascular Surgery
Richard B Schuessler, Anson M Lee, Spencer J Melby, Rochus K Voeller, Sydney L Gaynor, Shun-Ichiro Sakamoto, Ralph J Damiano
The Cox maze procedure is an effective treatment of atrial fibrillation, with a long-term freedom from recurrence greater than 90%. The original procedure was highly invasive and required cardiopulmonary bypass. Modifications of the procedure that eliminate the need for cardiopulmonary bypass have been proposed, including use of alternative energy sources to replace cut-and-sew lesions with lines of ablation made from the epicardium on the beating heart. This has been challenging because atrial wall muscle thickness is extremely variable, and the muscle can be covered with an epicardial layer of fat...
December 2009: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Mark A Wood, Amy L Ellenbogen, Vishesh Pathak, Kenneth A Ellenbogen, Vigneshwar Kasarajan
OBJECTIVE: Creation of transmural myocardial lesions with epicardial surgical devices to treat atrial fibrillation is difficult. A new cooled bipolar radiofrequency ablation probe was used to create transmural myocardial lesions under controlled conditions. METHODS: The Coolrail (AtriCure, Inc, West Chester, Ohio) is a handheld probe with 2 parallel 30-mm long radiofrequency conductors. Conductors are cooled by water irrigation. Lesions were delivered to epicardial surface of isolated bovine myocardium sliced 3- to 8-mm thick, with blood flow beneath tissue at 0 or 0...
February 2010: Journal of Thoracic and Cardiovascular Surgery
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