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percutaneous left atrial appendage closure

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https://www.readbyqxmd.com/read/28691914/residual-leaks-following-percutaneous-left-atrial-appendage-occlusion-assessment-and-management-implications
#1
Claire E Raphael, Paul A Friedman, Jacqueline Saw, Sorin V Pislaru, Thomas M Munger, David R Holmes
Left atrial appendage (LAA) closure for stroke prevention in the setting of non valvular atrial fibrillation is an alternative to oral anticoagulation in patients with increased bleeding risk. It allows similar reduction in thromboembolic events, in particular stroke, compared to warfarin. A common clinical dilemma is the management of patients with peri-device leak after LAA occlusion. This has been documented in both percutaneous as well as with surgical approaches. The specific definitions of leak severity, and the longer term clinical implications are poorly understood...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28595810/successful-percutaneous-retrieval-of-embolized-transcatheter-left-atrial-appendage-closure-device-watchman-using-a-modified-vascular-retrieval-forceps
#2
Zaher Fanari, Sachin Goel, Jeffrey A Goldstein
Transcatheter closure of the left atrial appendage (LAA) is increasingly considered as an alternative to oral anticoagulation in patients with previous major bleeding or at high-risk of bleeding. Device embolization with transcatheter LAA closure is a rare complication. Most cases are asymptomatic, but it can be life threatening. Depending on the location of embolization, percutaneous retrieval is feasible. Snares are usually used for retrieval, but other devices may be used. We report the case of a 63-year gentleman who underwent an uneventful LAA closure with Watchman device and routine testing next day showed embolization to the abdominal aorta...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28595459/percutaneous-closure-of-the-left-atrial-appendage-in-patients-with-diabetes-mellitus
#3
Obayda Azizy, Christos Rammos, Nils Lehmann, Tienush Rassaf, Hagen Kälsch
BACKGROUND: Left atrial appendage closure is a preventive treatment of atrial fibrillation-related thrombo-embolism. Patients with diabetes mellitus have increased risk for a negative outcome in percutaneous cardiac interventions. We assessed whether percutaneous left atrial appendage closure is safe and effective in patients with diabetes mellitus. METHODS: We included 78 patients (mean age of 74.4 ± 8.3 years) with indication for left atrial appendage closure in an open-label observational single-centre study...
June 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28565887/safety-and-efficacy-of-catheter-based-left-atrial-appendage-closure-in-patients-with-contraindications-for-long-term-anticoagulation
#4
Adrian Seidel, Abdul S Parwani, Florian Krackhardt, Martin Huemer, Philipp Attanasio, Wilhelm Haverkamp, Burkert Pieske, Leif-Hendrik Boldt
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) and the role of post interventional anticoagulation often evokes controversy in daily practice. This study aimed to evaluate LAAC in patients with non-rheumatic atrial fibrillation, high thromboembolic risk and contraindications for long-term anticoagulation in a clinical scenario. METHODS AND RESULTS: Between 2010-2015, LAAC was attempted in 118 patients (47 women). Devices were successfully implanted in 95% (Watchman™ device n=97, St...
May 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28504238/united-kingdom-coronary-and-structural-heart-interventions-from-2010-to-2015
#5
Peter F Ludman, Mark A de Belder, Simon Redwood, Adrian Banning
In the United Kingdom, a clinical data set is completed for every patient undergoing coronary intervention and certain structural interventions, and sent to central servers in the National Institute for Cardiovascular Outcomes Research (NICOR) on behalf of the British Cardiovascular Intervention Society (BCIS). These data are linked to the national mortality register. In addition, data are obtained about the structure of healthcare provision using an annual survey. Analyses of these data are provided for different audiences in several formats...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504234/spain-coronary-and-structural-heart-interventions-from-2010-to-2015
#6
Bruno García Del Blanco, Pilar Jiménez Quevedo, José D Diaz, Felipe Hernández, José Ramón Rumoroso, Manel Sabaté, José Maria de la Torre Hernandez, Ana Serrador, Armando Pérez de Prado, Javier Goicolea, Ramiro Trillo, Manolo Pan
Since 1990 The Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology has presented a yearly report on the data collected in the National Registry, with online support since 2010. The Steering Committee has analysed all data provided voluntarily by institutions, which consisted of a total of anywhere between 105 and 113 hospitals. Medical care was provided to a population of 46.8 million inhabitants in 2015. During this period, diagnostic procedures increased progressively from 2010, reaching a maximum of 145,836 in 2015, 86% (125,484) corresponding to coronary angiograms...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#7
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
#8
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/28457791/left-atrial-appendage-occlusion-for-stroke-prevention
#9
REVIEW
Arijit Chanda, John P Reilly
More than 2.3 million 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...
May 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28456775/atrial-natriuretic-peptide-and-brain-natriuretic-peptide-changes-after-epicardial-percutaneous-left-atrial-appendage-suture-ligation-using-lariat-device
#10
K Bartus, J Podolec, R J Lee, B Kapelak, J Sadowski, M Bartus, K Oles, P Ceranowicz, R Trabka, R Litwinowicz
Percutaneous left atrial appendage closure is an alternative treatment for stroke and systemic thromboembolism risk reduction in non-valvular atrial fibrillation (AF). However, the neurohormonal impact of epicardial exclusion of the left atrial appendage (LAA) with the LARIAT procedure is unknown. Evaluation of changes in atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels in AF patients underwent percutaneous LAA suture ligation. Sixty six patients underwent successfully percutaneous LAA suture ligation using LARIAT device...
February 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28429136/is-there-an-alternative-treatment-for-patients-intolerant-to-antiplatelet-therapy-if-percutaneous-left-atrial-appendage-closure-is-considered
#11
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)...
April 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28368849/first-in-man-percutaneous-laa-closure-with-an-amplatzer-amulet-and-triguard-embolic-protection-device-in-a-patient-with-laa-thrombus
#12
Francesca Del Furia, Marco B Ancona, Francesco Giannini, Richard J Jabbour, Damiano Regazzoli, Antonio Mangieri, Azeem Latib, Antonio Colombo, Matteo Montorfano
Percutaneous left atrial appendage (LAA) closure is currently utilized for the prophylaxis of thromboembolic cerebrovascular accidents in patients with non-valvular atrial fibrillation. The presence of LAA thrombus is usually considered a contraindication for the procedure, since there is a high risk of thrombus embolization. While reports in the literature have shown the feasibility of LAA closure in the presence of LAA thrombus with certain cerebral embolic protection devices, we present the first-in-man LAA closure of a patient with LAA thrombus using the TriGuard Embolic Protection Device...
April 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28360410/a-case-with-recurrent-free-floating-ball-thrombi-in-left-atrium
#13
Takayuki Yoshioka, Takeshige Mori, Yayoi Taniguchi, Sonoko Hirayama, Toru Ozawa, Sachiyo Iwata, Asumi Takei, Nobutaka Inoue
BACKGROUND A free-floating ball thrombus in the left atrium is a rare clinical condition. However, the diagnosis of this condition has been facilitated by the advent and development of echocardiography and multi-detector row computed tomography (MDCT) and several cases have been reported. CASE REPORT We report a case of a 75-year-old woman who had recurrent giant spherical thrombi in the left atrium. She was diagnosed with chronic atrial fibrillation at 52 years of age. A pacemaker implantation was performed at 54 years of age because of a complete atrioventricular block; and mitral valve replacement was performed for severe mitral regurgitation at 62 years of age...
March 31, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28281734/percutaneous-left-atrial-appendage-occlusion-new-perspectives-for-the-method
#14
Iwona Gorczyca-Michta, Beata Wożakowska-Kapłon
Ischemic stroke is a common complication of atrial fibrillation. Currently, oral anticoagulant drugs are the most commonly used method of stroke prevention. Left atrial appendage occlusion is thought to be the main source of thrombi in patients with AF. Percutaneous left atrial appendage is a valuable therapeutic option for selected high-risk patients with AF and contraindications for oral anticoagulation therapy. While complete closure of the left atrial appendage is the goal of a device implantation the variable nature of the left atrial appendage anatomy makes this goal difficult to achieve...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28245948/percutaneous-closure-of-iatrogenic-femoral-arteriovenous-fistula-using-a-covered-coronary-stent
#15
Juan Carlos Rama-Merchan, Ignacio Cruz-González, Javier Martín-Moreiras, Alejandro Diego-Nieto, Javier Rodríguez-Collado, Pedro Luis Sánchez
We present the case of a patient with a high-output fistula between the right superficial femoral artery and femoral vein after left atrial appendage closure successfully treated with a PK-Papyrus covered coronary stent using a 6F guiding catheter. To the best of our knowledge this is the first time a PK-Papyrus coronary stent has been used in this setting.
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28218603/frequency-and-clinical-course-of-cerebral-embolism-in-patients-undergoing-transcatheter-left-atrial-appendage-closure
#16
Nicolas Majunke, Franziska Eplinius, Matthias Gutberlet, Sven Moebius-Winkler, Ingo Daehnert, Matthias Grothoff, Stephan Schürer, Norman Mangner, Philipp Lurz, Sandra Erbs, Katharina Kirsch, Gerhard Schuler, Marcus Sandri
AIMS: To assess silent and clinically apparent cerebral embolic events in patients undergoing transcatheter left atrial appendage closure. METHODS AND RESULTS: In this prospective single-center study 28 patients underwent percutaneous closure of the left atrial appendage. In all patients a diffusion-weighted magnetic resonance imaging (DWI-MRI) study was performed before, the day after the procedure and during routine follow-up after 45 days. All patients underwent neurological assessment at the time of DWI-MRI...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28188931/percutaneous-left-atrial-appendage-closure-improves-left-atrial-mechanical-function-through-frank-starling-mechanism
#17
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 PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation), an objective improvement in quality of life was observed after LAA closure. OBJECTIVE: The purpose of this study was to investigate the impact of LAA closure on LA transport function...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28149625/five-years-of-keeping-a-watch-on-the-left-atrial-appendage-how-has-the-watchman-fared
#18
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/28128883/early-canadian-multicenter-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#19
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/28089095/characteristics-of-anatomy-and-function-of-the-left-atrial-appendage-and-their-relationships-in-patients-with-cardioembolic-stroke-a-3-dimensional-transesophageal-echocardiography-study
#20
Yuki Matsumoto, Yoshihiro Morino, Akiko Kumagai, Maiko Hozawa, Motoyuki Nakamura, Yasuo Terayama, Atsushi Tashiro
BACKGROUND: Increasing attention is being paid to the left atrial appendage (LAA) in the context of risk stratification in cardioembolic stroke (CES) and the requirement for meticulous planning of percutaneous closure device implantation. However, detailed systematic assessment of the LAA remains limited. METHODS: This study evaluated the anatomy and function of LAA using 3-dimensional transesophageal echocardiography (3D-TEE) on 194 consecutive patients older than 50 years old hospitalized exclusively for CES...
March 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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