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https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#1
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28203397/is-left-atrial-appendage-isolation-a-pyrrhic-victory-in-the-effort-to-treat-atrial-fibrillation
#2
EDITORIAL
T Jared Bunch, John D Day
No abstract text is available yet for this article.
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28198520/twelve-month-follow-up-of-left-atrial-appendage-occlusion-with-amplatzer-amulet
#3
Caroline Kleinecke, Jai-Wun Park, Martin Gödde, Konstantin Zintl, Steffen Schnupp, Johannes Brachmann
BACKGROUND: The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second generation Amplatzer device for left atrial appendage occlusion for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. METHODS: In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the Amplatzer Amulet device...
February 15, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28191906/intracardiac-echocardiography-for-verification-for-left-atrial-appendage-thrombus-presence-detected-by-transesophageal-echocardiography-the-actionice-ii-study
#4
Jakub Baran, Beata Zaborska, Roman Piotrowski, Malgorzata Sikora-Frąc, Ewa Pilichowska-Paszkiet, Piotr Kułakowski
BACKGROUND: Transesophageal echocardiography (TEE) remains the gold standard for exclusion of left atrial appendage (LAA) thrombus in patients scheduled for direct electrical cardioversion (DEC) or atrial fibrillation (AF) ablation. Recently, intracardiac echocardiography (ICE) of the pulmonary artery (PA) has been shown to provide excellent LAA images and to be useful in verification of equivocal TEE findings. HYPOTHESIS: ICE of the PA may have a role in detecting false-positive TEE results...
February 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28188931/percutaneous-left-atrial-appendage-closure-improves-left-atrial-mechanical-function-through-frank-starling-mechanism
#5
Augustin Coisne, Rosario Pilato, François Brigadeau, Didier Klug, Christelle Marquie, Zouheir Souissi, Marjorie Richardson, Stéphanie Mouton, Anne-Sophie Polge, Patrizio Lancellotti, Dominique Lacroix, David Montaigne
BACKGROUND: Modifications in left atrial (LA) flow velocities after left atrial appendage (LAA) exclusion have been shown in animal and ex vivo models. In a substudy of the PROTECT AF, an objective improvement in quality of life was observed after LAA closure. OBJECTIVE: We aimed to investigate the impact of LAA closure on LA transport function METHODS: Comprehensive Transthoracic echocardiography (TTE) evaluation (2D/3D, 2D speckle tracking) was prospectively performed before and after LAA closure (at discharge and 45 days after procedure) in 33 patients...
February 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28185355/catheter-ablation-of-ventricular-tachycardia-in-patients-with-mitraclip-device-preliminary-findings
#6
Laurent M Haegeli, Giuseppe D'Angelo, Nicola Trevisi, Stefano Stella, Alexander Breitenstein, Firat Duru, Corinna Brunckhorst, Paolo Della Bella
INTRODUCTION: Patients with mitral regurgitation are increasingly treated by percutaneous implantation of a MitraClip device. We investigate the feasibility and safety of the transmitral catheter route for catheter ablation of VT (ventricular tachycardia) in these patients. METHODS: The mitral valve with the MitraClip in situ was crossed under transesophageal three-dimensional echocardiographic and fluoroscopic guidance using a steerable sheath for ablation of the left ventricle...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28183749/rapid-and-affordable-3-dimensional-prototyping-for-left-atrial-appendage-closure-planning
#7
Houman Khalili, Ralph E Gentry, Melissa A Stevens, Steven L Almany, Subhash Banerjee, David E Haines, George S Hanzel
No abstract text is available yet for this article.
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28181272/left-atrial-appendage-closure-for-stroke-prevention-more-choice-is-always-a-good-thing
#8
EDITORIAL
Rong Bai
While oral anticoagulants (OACs) remains the main strategy of prevention of thromboembolic event in patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) has become an alternative recently. The concept of this technique is based on the understanding that in more than 90% non-valvular AF patients, the thrombi form in the left atrial appendage (LAA), so excluding the LAA from the systemic circulation can prevent stroke or peripheral arterial embolization. To achieve this goal, novel trans-catheter techniques have been developed to either occlude the LAA endocardially or ligate the LAA epicardially...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28179613/left-atrial-appendage-thrombi-formation-in-japanese-non-valvular-atrial-fibrillation-patients-during-anticoagulation-therapy%C3%A3-warfarin-vs-direct-oral-anticoagulants
#9
Mihoko Kawabata, Masahiko Goya, Takeshi Sasaki, Shingo Maeda, Yasuhiro Shirai, Takuro Nishimura, Takakatsu Yoshitake, Shinya Shiohira, Mitsuaki Isobe, Kenzo Hirao
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia, associated with increased cardiovascular morbidity and mortality including thromboembolic events. The aims of this study were to assess the prevalence of left atrial appendage (LAA) thrombi in Japanese non-valvular atrial fibrillation (NVAF) patients undergoing preprocedural transesophageal echocardiography (TEE) during anticoagulation therapy, and to compare the efficacy of warfarin and direct oral anticoagulants (DOAC)...
February 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28174408/-double-valve-replacement-and-tricuspid-annuloplasty-in-a-patient-with-situs-inversus-totalis-and-mirror-image-dextrocardia-report-of-a-case
#10
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi, Kazuhito Tatsu
Situs inversus totalis and mirror-image dextrocardia is a rare congenital anomaly. A 79-year-old man with a history of atrial fibrillation presented to our hospital with chest oppression. Chest X-ray and computed tomography showed mirror-image dextrocardia and situs inversus totalis. Echocardiography revealed severe mitral and aortic regurgitation and mild tricuspid regurgitation. Mitral and aortic valve replacement using bioprosthesises, tricuspid annuloplasty and closure of the left atrial appendage were successfully performed...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28154603/underdevelopment-of-left-atrial-appendage
#11
In Geol Song, Sung-Hwan Kim, Yong-Seog Oh, Tai-Ho Rho
A patient was admitted for catheter ablation of atrial fibrillation. Cardiac computed tomography and transesophageal echocardiography revealed the absence of the left atrial appendage. However, the right atrial appendage looked normal and the level of pro B-natriuretic peptide was within normal limits. Successful catheter ablation was performed without any procedural complications and the sinus rhythm was appropriately maintained for 10 months with an antiarrhythmic drug.
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28153350/incidence-and-predictors-of-left-atrial-appendage-thrombus-in-patients-treated-with-nonvitamin-k-oral-anticoagulants-versus-warfarin-before-catheter-ablation-for-atrial-fibrillation
#12
Joanne Wyrembak, Kristen B Campbell, Benjamin A Steinberg, Tristram D Bahnson, James P Daubert, Eric J Velazquez, Zainab Samad, Brett D Atwater
The utility of routine transesophageal echocardiography (TEE) to exclude left atrial appendage (LAA) thrombus before atrial fibrillation (AF) ablation in patients treated with nonvitamin K oral anticoagulant (NOAC) therapy is unclear. This single-center retrospective study sought to investigate the incidence of LAA thrombus in patients undergoing routine TEE before AF ablation treated with warfarin or NOAC therapy. We included 937 routine pre-AF ablation TEE procedures performed in patients treated with warfarin (n = 517) or NOAC (n = 420)...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28149625/five-years-of-keeping-a-watch-on-the-left-atrial-appendage-how-has-the-watchman-fared
#13
COMMENT
Mohammad-Ali Jazayeri, Venkat Vuddanda, Valay Parikh, Madhav Lavu, Donita Atkins, Y Madhu Reddy, Jayant Nath, Dhanunjaya R Lakkireddy
Left atrial appendage closure (LAAC) is a promising site-directed therapy for stroke prevention in patients with non-valvular atrial fibrillation (AF) who are ineligible or contraindicated for long-term oral anticoagulation. A variety of LAAC modalities are available, including percutaneous endocardial occluder devices such as WATCHMAN(TM) (Boston Scientific Corp., Marlborough, MA, USA), and an ever-increasing body of evidence is helping to define the optimal use of each technique. Similarly increased experience with LAAC has revealed challenges such as device-related thrombi and peri-device leaks for which the long-term significance and appropriate management are areas of active investigation...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28145040/device-associated-thrombus-formation-after-left-atrial-appendage-occlusion-a-systematic-review-of-events-reported-with-the-watchman-the-amplatzer-cardiac-plug-and-the-amulet
#14
Mathieu Lempereur, Adel Aminian, Xavier Freixa, Sameer Gafoor, Joelle Kefer, Apostolos Tzikas, Victor Legrand, Jacqueline Saw
OBJECTIVES: This study aimed to provide a systematic review of device-associated thrombosis (DAT) after left atrial appendage occlusion (LAAO) with the Watchman, Amplatzer Cardiac Plug, and Amulet devices. BACKGROUND: DAT is known as a complication of LAAO but data about its clinical impact is scarce. METHODS: A systematic review of studies evaluating the incidence, treatment and clinical implications of DAT from January 2008 to September 2015 was conducted...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28130587/a-novel-method-to-estimate-blood-flow-velocity-in-the-left-atrial-appendage-using-enhanced-computed-tomography-role-of-hounsfield-unit-density-ratio-at-two-distinct-points-within-the-left-atrial-appendage
#15
Ryobun Yasuoka, Takashi Kurita, Yasuhito Kotake, Yuzuru Akaiwa, Naotaka Hashiguchi, Koichiro Motoki, Hiromi Yamamoto, Kazuhiro Kobuke, Yoshitaka Iwanaga, Yutaka Hirano, Shunichi Miyazaki
Low blood flow velocity in the left atrial appendage (LAA) indicates a high risk of thromboembolism. Although transesophageal echocardiography (TEE) has been the standard method with which to evaluate the LAA blood flow velocity, a clinically noninvasive method is desired. We hypothesized that the ratio of the Hounsfield unit (HU) density at two distinct points within the LAA represents the blood flow velocity in the LAA. We retrospectively investigated 60 consecutive patients with atrial fibrillation (paroxysmal type, n = 29) who underwent enhanced computed tomography (CT) and TEE...
January 27, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28129320/totally-endoscopic-robotic-left-atrial-appendage-closure-demonstrates-high-success-rate
#16
Alison F Ward, Robert M Applebaum, Nana Toyoda, Ans Fakiha, Peter J Neuburger, Jennie Ngai, Robert G Nampiaparampil, David W Yaffee, Didier F Loulmet, Eugene A Grossi
OBJECTIVE: In patients with atrial fibrillation, 90% of embolic strokes originate from the left atrial appendage (LAA). Successful exclusion of the LAA is associated with a lower stroke rate in patients with atrial fibrillation. Surgical oversewing of the LAA is often incomplete when evaluated with transesophageal echocardiogram (TEE). External closure techniques of suturing and stapling have also demonstrated high failure rates with persistent flow and large stumps. We hypothesized that the precise visualization of a robotic LAA closure (RLAAC) would result in superior closure rates...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28129318/initial-experience-with-minimally-invasive-surgical-exclusion-of-the-left-atrial-appendage-with-an-epicardial-clip
#17
Nathan E Smith, Jeevan Joseph, John Morgan, Saqib Masroor
OBJECTIVE: Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28128883/early-canadian-multi-center-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#18
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There is limited data with WATCHMAN for left atrial appendage (LAA) closure in patients with non-valvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at 4 major Canadian centers. Indications for LAA closure were CHADS2 ≥ 1 or CHA2 DS2 -VASc ≥ 2, and contraindication/intolerance to or failure on anticoagulation...
January 27, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28121919/roles-of-real-time-three-dimensional-transesophageal-echocardiography-in-peri-operation-of-transcatheter-left-atrial-appendage-closure
#19
Qing Zhou, Hongning Song, Lan Zhang, Qing Deng, Jinling Chen, Bo Hu, Yijia Wang, Ruiqiang Guo
Left atrial appendage (LAA) closure is a new treatment option for the prevention of stroke in patients with nonvalvular atrial fibrillation (AF). Conventional 2-dimensional transesophageal echocardiography (2D TEE) has some limitations in the imaging assessment of LAA closure. Real-time 3-dimensional transesophageal echocardiography (RT-3D TEE) allows for detailed morphologic assessment of the LAA. In this study, we aim to determine the clinical values of RT-3D TEE in the periprocedure of LAA closure.Thirty-eight persistent or paroxysmal AF patients with indications for LAA closure were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28115807/functional-remodeling-of-both-atria-is-associated-with-occurrence-of-stroke-in-patients-with-paroxysmal-and-persistent-atrial-fibrillation
#20
Hsuan-Ming Tsao, Wei-Chih Hu, Ping-Huang Tsai, Chao-Lin Lee, Hsueh-Han Wang, Shih-Lin Chang, Tze-Fan Chao, Shih-Ann Chen
BACKGROUND: It is critical to recognize high risk patients who are prone to develop stroke in the management of atrial fibrillation (AF). The purpose of this study was to identify the determinants of AF related stroke by assessing the anatomical and functional remodeling of cardiac chambers. METHODS: We compared the cardiac structure and function of 28 consecutive patients with paroxysmal and persistent AF-related stroke with 69 patients with AF and 21 controls without stroke using contrast-enhanced 64-slice multi-detector computed tomography during sinus rhythm...
January 2017: Acta Cardiologica Sinica
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