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Watchman LAA

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https://www.readbyqxmd.com/read/28546017/delayed-left-atrial-appendage-contrast-filling-in-computed-tomograms-after-percutaneous-left-atrial-appendage-occlusion
#1
Yeong-Min Lim, Jung-Sun Kim, Tae-Hoon Kim, Jae-Sun Uhm, Chi Young Shim, Boyoung Joung, Geu-Ru Hong, Moon-Hyoung Lee, Yang-Soo Jang, Hui-Nam Pak
BACKGROUND: The gold standard for the follow-up of left atrial appendage occlusion (LAAO) is performing transesophageal echocardiogram (TEE) at 45 days after LAAO; however, the duration for complete LAA seal-off after percutaneous LAAO is unknown in humans. We retrospectively evaluated the LAA contrast-filling (CF) rate in follow-up cardiac computed tomography (CT) scans after LAAO. METHODS: We included 35 patients (age 67.5±10.9 years, CHA2DS2VASc 4.2±1.6, HAS-BLED 3...
May 22, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28506939/printed-mdct-3d-models-for-prediction-of-left-atrial-appendage-laa-occluder-device-size-a-feasibility-study
#2
Orly Goitein, Noam Fink, Victor Guetta, Roy Beinart, Yafim Brodov, Eli Konen, David Goitein, Elio Di Segni, Avishay Grupper, Michael Glikson
AIMS: Trans-esophageal echocardiography (TEE) and MDCT currently serve as imaging modalities for left atrial appendage (LAA) occlusion pre-procedural planning. We assessed the feasibility of multi-detector CT (MDCT) based models to predict the correct size of device for LAA occlusion procedures. METHODS AND RESULTS: Patients planned for LAA occlusion underwent MDCT before implantation, which was used for creating and printing 3D LAA models. Three cardiologists evaluated the 3D models and predicted the correct size of the device by manual manipulation, these predictions were compared with the actual device implanted during the procedure...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#3
Julia Seeger, Ralf Birkemeyer, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. METHODS AND RESULTS: Twelve consecutive non-valvular atrial fibrillation patients (age 76.6±7.8years) at high risk for stroke (CHA2DS2-VASc-Score 5.5±0.9) and bleeding (HAS-BLED-Score 3.8±0.9), received LAA closure with the Watchman FLX...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28477098/predictors-of-thrombus-formation-after-percutaneous-left-atrial-appendage-closure-using-the-watchman-device
#4
Hidehiro Kaneko, Michael Neuss, Jens Weissenborn, Christian Butter
Percutaneous left atrial appendage (LAA) closure using the WATCHMAN device is a novel option for prevention of stroke associated with atrial fibrillation. However, device-related thrombus (DRT) formation is a concern after WATCHMAN implantation and the predictors of DRT still remain unclear. We aimed to clarify the predictors of DRT after WATCHMAN implantation by analyzing 78 patients (50 males, 72 ± 8 years, average CHA2DS2-VASc score of 4.3 + 1.8) who had undergone WATCHMAN implantation. WATCHMAN was successfully implanted in all patients and four (5%) developed DRT...
May 5, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28471099/watchman-in-ascending-aorta-for-systemic-protection-waasp-novel-use-of-watchman-in-ascending-aorta-for-embolic-protection-first-in-man
#5
Pradeep K Yadav, Dee Dee Wang, Marvin H Eng, William W O'Neill
We report two cases where left atrial appendage closure (LAA) with Watchman was successfully performed despite presence of definite LAA thrombus. Because there was the risk of thrombus dislodgement, we transiently placed an additional Watchman device in the ascending aorta for embolic protection. © 2017 Wiley Periodicals, Inc.
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28461140/laa-occluder-device-for-stroke-prevention-data-on-watchman-and-other-laa-occluders
#6
REVIEW
Martin W Bergmann
NOAC therapy has become the standard for stroke prevention in patients with atrial fibrillation. Yet some patients suffer extracranial bleeding events or have other reasons to seek non-pharmacologic stroke protection. LAA occlusion with the WATCHMAN device has been proven safe and effective for such patients and is now recommended in current guidelines for this patient group; other devices also seek approval.
March 24, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28457791/left-atrial-appendage-occlusion-for-stroke-prevention
#7
Arijit Chanda, John P Reilly
More than 2.3 millions adults in the United States have atrial fibrillation (AF), which exposes them to a 5- fold increased risk of stroke. The left atrial appendage (LAA) appears to be the source of thrombus formation in the vast majority of these patients. Anticoagulation significantly reduces the risk of stroke, but often we encounter patients who have absolute or relative contraindication to anticoagulation. Percutaneous LAA exclusion offers an alternative to anticoagulation to decrease the risk of stroke...
April 27, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28409845/procedural-success-and-intra-hospital-outcome-related-to-left-atrial-appendage-morphology-in-patients-that-receive-an-interventional-left-atrial-appendage-closure
#8
Christian Fastner, Michael Behnes, Benjamin Sartorius, Annika Wenke, Ibrahim El-Battrawy, Uzair Ansari, Ishar-Singh Gill, Martin Borggrefe, Ibrahim Akin
BACKGROUND: The interventional left atrial appendage (LAA) closure represents an emerging alternative to oral anticoagulation for stroke prevention in certain atrial fibrillation patients. Preliminary results have suggested high procedural success rates and fewer peri-interventional complications; however, there persists an insufficient understanding of the role of many underlying confounding variables (e.g., anatomical characteristics). HYPOTHESIS: It was investigated whether varying LAA morphologies influence procedural success as well as in-hospital outcome...
April 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28293114/novel-stroke-risk-reduction-in-atrial-fibrillation-left-atrial-appendage-occlusion-with-a-focus-on-the-watchman-closure-device
#9
REVIEW
Arash Alipour, Lisette I S Wintgens, Martin J Swaans, Jippe C Balt, Benno J W M Rensing, Lucas V A Boersma
Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS2 or CHA2DS2-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28256020/left-atrial-anatomy-and-patient-related-factors-associated-with-adverse-outcomes-with-the-watchman-device-a-real-world-experience
#10
Shishir Murarka, Mohamad Lazkani, Soundos Moualla, Divya Ratan Verma, Ashish Pershad
OBJECTIVE: This study sought to identify patient and left atrial morphology specific factors associated with early complications for left atrial appendage occlusion with the Watchman™ (Boston Scientific, Natick, MA) device. BACKGROUND: Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation, however, long-term OAC compliance is poor. In randomized control trials, the Watchman™ device has demonstrated superiority over OAC with warfarin for all cause and cardiovascular mortality and hemorrhagic stroke...
April 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#11
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
February 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28128883/early-canadian-multicenter-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#12
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There are limited data with WATCHMAN (Boston Scientific Corporation, Natick, MA, USA) for left atrial appendage (LAA) closure in patients with nonvalvular 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 four major Canadian centers...
April 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28070743/cardiac-ct-angiography-ccta-predicts-left-atrial-appendage-occluder-device-size-and-procedure-outcome
#13
Orly Goitein, Noam Fink, Ilan Hay, Elio Di Segni, Victor Guetta, David Goitein, Yafim Brodov, Eli Konen, Michael Glikson
AIM: To investigate the role of cardiac CT angiography (CCTA) in predicting optimal left atrial appendage (LAA) occluder size and procedure outcome. METHODS AND RESULTS: Thirty-six patients underwent pre-procedural CCTA. CCTA and TEE LAA orifice diameters and perimeters were compared with the implanted device size. CCTA 3D configuration was correlated with procedure outcome. Watchman™ device (N = 18): diameters were 21 ± 4, 26 ± 5 and 25 ± 3 mm for TEE, CCTA and inserted device, respectively...
January 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28013284/ct-sizing-for-left-atrial-appendage-closure-is-associated-with-favourable-outcomes-for-procedural-safety
#14
Adil Rajwani, Adam J Nelson, Masoumeh G Shirazi, Patrick J S Disney, Karen S L Teo, Dennis T L Wong, Glenn D Young, Stephen G Worthley
AIMS: We evaluated the utility of computerized tomography (CT) with respect to sizing work-up for percutaneous left atrial appendage (LAA) closure, and implications for procedural safety and outcomes. METHODS AND RESULTS: Contrast-enhanced multi-detector CT was routinely conducted to guide sizing for LAA closure in addition to transoesophageal echocardiography (TOE). Procedural safety and efficacy were prospectively assessed. Across 73 consecutive cases there were no device-related procedural complications, and no severe leaks...
December 24, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/27943538/catheter-ablation-for-atrial-fibrillation-in-patients-with-watchman-left-atrial-appendage-occlusion-device-results-from-a-multicenter-registry
#15
Mohit K Turagam, Madhav Lavu, Muhammad R Afzal, Venkat Vuddanda, Mohammad-Ali Jazayeri, Valay Parikh, Donita Atkins, Sudharani Bommana, Luigi DI Biase, Rodney Horton, Rong Bai, Vijay Swarup, Jie Cheng, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: There have been an increasing number of atrial fibrillation (AF) patients with Watchman left atrial appendage occlusion (LAAO) device, requiring catheter ablation (CA) for maintenance of normal sinus rhythm. In this study, we describe our experience with the feasibility and safety of CA in patients with a preexisting Watchman LAAO device. METHODS: This was a retrospective multicenter AF registry of 60 patients with Watchman LAAO device who underwent CA for AF...
February 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27884358/application-of-3-dimensional-computed-tomographic-image-guidance-to-watchman-implantation-and-impact-on%C3%A2-early-operator-learning-curve-single-center-experience
#16
Dee Dee Wang, Marvin Eng, Daniel Kupsky, Eric Myers, Michael Forbes, Mehnaz Rahman, Mohammad Zaidan, Sachin Parikh, Janet Wyman, Milan Pantelic, Thomas Song, Jeff Nadig, Patrick Karabon, Adam Greenbaum, William O'Neill
OBJECTIVES: The aim of this study was to examine the impact of 3-dimensional (3D) computed tomographic (CT) guided procedural planning for left atrial appendage (LAA) occlusion on the early operator WATCHMAN learning curve. BACKGROUND: Traditional WATCHMAN implantation is dependent on 2-dimensional transesophageal echocardiographic (TEE) sizing and intraprocedural guidance. METHODS: LAA occlusion with the WATCHMAN device was performed in 53 patients...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27815629/pulmonary-artery-perforation-and-coronary-air-embolism-two-fatal-outcomes-in-percutaneous-left-atrial-appendage-occlusion
#17
J Zwirner, R Bayer, C Hädrich, A Bollmann, N Klein, J Dreßler, B Ondruschka
Percutaneous left atrial appendage (LAA) closure is a routinely performed method to reduce the risk of stroke in patients suffering from atrial fibrillation, when an oral anticoagulation is no longer indicated due to relevant bleeding complications. Currently, the Amplatzer Amulet and the Watchman system are two equally used systems. While there is an acute success rate of more than 95 per cent for this intervention, several minor and major complications such as pericardial effusions, air embolism, vascular lesions in proximity to the heart or even death can occur...
January 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27696317/left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation
#18
REVIEW
Erin A Fender, Jawad G Kiani, David R Holmes
PURPOSE OF REVIEW: Anticoagulant therapy effectively reduces the incidence of stroke in patients with atrial fibrillation (AF) but is underutilized and frequently contraindicated. The left atrial appendage (LAA) is the primary site of thrombus formation in AF patients. Surgical and percutaneous appendage closure has been evaluated as a site-specific therapy to reduce systemic thromboembolism. RECENT FINDINGS: We will review LAA closure techniques, examine recent outcome data, and discuss the indications for, and potential complications of, each approach...
November 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27679417/retrieval-of-embolized-left-atrial-appendage-devices
#19
Peter Fahmy, Lim Eng, Jacqueline Saw
Percutaneous left atrial appendage (LAA) closure is gaining interest as an alternative option for prevention of strokes in patients with Atrial Fibrillation (AF), especially for those with contraindications to anticoagulation. Complications from these procedures are well described in the medical literature. LAA closures may lead to pericardial effusion, device-associated thrombus, and device embolization. Understanding the reasons for embolization, strategies to avoid embolization, and the techniques for retrieval of LAA devices (ACP/AMULET and WATCHMAN) should be appreciated by endovascular implanters...
September 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27621674/percutaneous-left-atrial-appendage-closure-devices-safety-efficacy-and-clinical-utility
#20
REVIEW
Martin J Swaans, Lisette Is Wintgens, Arash Alipour, Benno Jwm Rensing, Lucas Va Boersma
Atrial fibrillation (AF) is the most common arrhythmia treated in the clinical practice. One of the major complications of AF is a thromboembolic cerebral ischemic event. Up to 20% of all strokes are caused by AF. Thromboembolic cerebral ischemic event in patients with AF occurs due to atrial thrombi, mainly from the left atrial appendage (LAA). Prevention of clot formation with antiplatelet agents and especially oral anticoagulants (vitamin K antagonists or newer oral anticoagulants) has been shown to be effective in reducing the stroke risk in patients with AF but has several drawbacks with (major) bleedings as the most important disadvantage...
2016: Medical Devices: Evidence and Research
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