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percutaneous left atrial appendage closure

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https://www.readbyqxmd.com/read/27898435/percutaneous-left-atrial-appendage-closure-current-state-of-the-art
#1
Mohammad-Ali Jazayeri, Venkat Vuddanda, Valay Parikh, Dhanunjaya R Lakkireddy
PURPOSE OF REVIEW: The authors reviewed the seminal and more recent literature surrounding the major modalities for percutaneous left atrial appendage closure used in contemporary practice, with particular emphasis on safety and efficacy, technical challenges, and future developments. RECENT FINDINGS: Along with the continued practice of surgical left atrial appendage closure, which has evolved substantially with the advent of clipping techniques, a number of percutaneous methods have been developed to close the left atrial appendage with endocardial, epicardial, and hybrid approaches...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27860249/left-atrial-appendage-closure-initial-experience-with-the-ultraseal-device
#2
Ander Regueiro, Mathieu Bernier, Gilles O'Hara, Kim O'Connor, Jean-Michel Paradis, Jonathan Beaudoin, Tania Rodriguez-Gabella, Jean Champagne, Josep Rodés-Cabau
OBJECTIVES: We report the initial experience of percutaneous left atrial appendage (LAA) closure with the Ultraseal device. BACKGROUND: LAA closure is an alternative to oral anticoagulation for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) and high risk of bleeding. The Ultraseal device is a new LAA closure prosthesis that consists of a distal soft bulb and a proximal sail attached by an articulating joint that allows a high degree of device conformability to the different variations of the LAA anatomy...
November 17, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27826128/durability-of-wide-area-left-atrial-appendage-isolation-results-from-extensive-catheter-ablation-for-the-treatment-of-persistent-atrial-fibrillation
#3
Bruno Reissmann, Andreas Rillig, Erik Wissner, Roland Tilz, Michael Schlüter, Christian Sohns, Christian Heeger, Shibu Mathew, Tilman Maurer, Christine Lemes, Thomas Fink, Peter Wohlmuth, Francesco Santoro, Johannes Riedl, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Extensive ablation strategies are currently performed in addition to pulmonary vein isolation (PVI) to improve the clinical outcome of patients with drug-refractory persistent atrial fibrillation (AF). Ablation of complex fractionated atrial electrograms (CFAE), linear lesions and/or isolation of the left atrial appendage (LAA) are thought to improve arrhythmia-free survival. OBJECTIVE: This study sought to assess the durability of wide-area LAA isolation (LAAI) achieved by PVI, an anterior line and a mitral isthmus line...
November 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27824417/-anticoagulation-and-new-therapeutic-options-in-atrial-fibrillation
#4
Karl Mischke
Oral anticoagulation plays an essential role in the treatment of patients with atrial fibrillation as it is indicated for most patients to reduce the risk of stroke. It is prudent to assess the risks of stroke and bleeding using the CHA2DS2-VASc and HAS-BLED scores. Oral anticoagulation is indicated in general for all patients with valvular atrial fibrillation (atrial fibrillation in moderate to severe mitral stenosis or mechanical prosthetic valve) as well as for patients with a CHA2DS2-VASc-Score of 1 - 2 points or higher...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27816552/post-fda-approval-initial-us-clinical-experience-with-watchman-left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation
#5
Vivek Y Reddy, Douglas N Gibson, Saibal Kar, William O'Neill, Shephal K Doshi, Rodney P Horton, Maurice Buchbinder, Nicole T Gordon, David R Holmes
BACKGROUND: Left atrial appendage closure (LAAC) using the Watchman device was FDA-approved as a stroke prevention alternative to warfarin for patients with non-valvular atrial fibrillation. However, clinical decision-making is confounded by the fact that while LAAC avoids the anticoagulant-related lifetime risk of bleeding, implantation is associated with up-front complications. Thus, enthusiasm for LAAC as a treatment option has been appropriately tempered, particularly as the therapy is introduced beyond the clinical trial sites into general clinical practice...
October 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27815629/pulmonary-artery-perforation-and-coronary-air-embolism-two-fatal-outcomes-in-percutaneous-left-atrial-appendage-occlusion
#6
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...
November 4, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27807929/imaging-for-percutaneous-left-atrial-appendage-closure
#7
Roshan Prakash, Jacqueline Saw
Percutaneous left atrial appendage (LAA) closure is increasingly performed worldwide as an alternative to long-term oral anticoagulation, especially for patients who are considered ineligible for anticoagulation. This is a complex procedure with success that hinges upon good understanding of the LAA and surrounding structures anatomy. Multimodality imaging can provide important three-dimensional appreciation of the LAA anatomy, which facilitates procedural safety and success. Thus, proceduralists and imagers involved with LAA closure should have good comprehension of such imaging modalities (cardiac CT angiography, transesophageal echocardiography, and/or intracardiac echocardiography) prior to embarking on this procedure...
November 3, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27800191/successful-left-atrial-appendage-occlusion-with-the-new-generation-amulet%C3%A2-device-after-late-occurring-embolization-of-an-amplatzer%C3%A2-cardiac-plug-in-a-patient-with-repetitive-strokes
#8
Marco R Schroeter, Wolfgang Schillinger
The Amplatzer Cardiac Plug (ACP) is one of the most commonly used devices for percutaneous left atrial appendage (LAA) closure in order to prevent a stroke in patients with atrial fibrillation and contraindication for long-term oral anticoagulation therapy. We have previously described a patient who had experienced an embolization of the ACP device about 12 months after implantation and the device could be percutaneously retrieved. A few years later, he suffered from a posterior stroke and a stroke located in the brainstem as well as a transischemic attack (TIA)...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27746992/percutaneous-left-atrial-appendage-closure-here-to-stay
#9
COMMENT
Lim Eng, Jacqueline Saw
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27720416/safety-and-effectiveness-of-percutaneous-closure-of-left-atrial-appendage-in-patients-with-intracranial-hemorrhage
#10
Ignacio Cruz-González, Juan C Rama-Merchan, Sandra Martínez-Peralta, Luis López-Mesonero, Javier Rodríguez-Collado, Pedro L Sánchez
No abstract text is available yet for this article.
October 5, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27716687/different-transseptal-puncture-for-different-procedures-optimization-of-left-atrial-catheterization-guided-by-transesophageal-echocardiography
#11
Andrea Radinovic, Patrizio Mazzone, Giovanni Landoni, Eustachio Agricola, Damiano Regazzoli, Paolo Della Bella
BACKGROUND: Left atrial catheterization through transseptal puncture is frequently performed in cardiac catheterization procedures. Appropriate transseptal puncture is critical to achieve procedural success. AIMS: The aim of the study is to evaluate the feasibility of selective transseptal punctures, using a modified radiofrequency (RF) transseptal needle and transesophageal echocardiography (TEE), in different types of procedures that require specific sites of left atrial catheterization...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27696317/left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation
#12
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/27693110/percutaneous-balloon-mitral-valvuloplasty-and-closure-of-the-left-atrial-appendage-synergy-of-two-procedures-in-one-percutaneous-intervention
#13
Daniele Gemma, Raúl Moreno Gómez, Jaime Fernández de Bobadilla, Guillermo Galeote García, Teresa López Fernandez, Jose R López-Mínguez, José L López-Sendón
Mitral stenosis (MS) is frequently associated with the development of atrial fibrillation (AF) as a consequence of hemodynamic and inflammatory changes in the left atrium. Both conditions predispose to thrombus formation, with frequent involvement of the left atrial appendage (LAA), and consequent increase in the incidence of systemic thromboembolic events. Percutaneous mitral valvuloplasty (PMV) reduces the risk of thromboembolism in patients with significant mitral stenosis. Percutaneous LAA closure is also associated with a reduction in thromboembolic risk in patients with AF, but there are no data regarding the use of this technique in patients with significant mitral valve disease...
September 29, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27679417/retrieval-of-embolized-left-atrial-appendage-devices
#14
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
#15
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
https://www.readbyqxmd.com/read/27587437/efficacy-and-safety-of-left-atrial-appendage-closure-versus-medical-treatment-in-atrial-fibrillation-a-network-meta-analysis-from-randomised-trials
#16
Shweta Sahay, Luis Nombela-Franco, Josep Rodes-Cabau, Pilar Jimenez-Quevedo, Pablo Salinas, Corina Biagioni, Ivan Nuñez-Gil, Nieves Gonzalo, Jose Alberto de Agustín, Maria Del Trigo, Leopoldo Perez de Isla, Antonio Fernández-Ortiz, Javier Escaned, Carlos Macaya
BACKGROUND: The effectiveness of vitamin K antagonist (VKA) versus placebo and antiplatelet therapy (APT) is well established for stroke prevention in atrial fibrillation (AF). Non-vitamin K antagonist oral anticoagulants (NOAC) are mostly superior to VKA in stroke and intracranial bleeding prevention. Recent randomised controlled trials (RCTs) suggested the non-inferiority of percutaneous left atrial appendage closure (LAAC) versus VKA. However, comparisons between LAAC versus placebo, APT or NOAC are lacking...
September 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27571335/-anmco-aiac-sici-gise-sic-sicch-consensus-document-percutaneous-left-atrial-appendage-occlusion-in-patients-with-nonvalvular-atrial-fibrillation-indications-patient-selection-competences-organization-and-operator-training
#17
Gavino Casu, Michele Massimo Gulizia, Giulio Molon, Patrizio Mazzone, Andrea Audo, Giancarlo Casolo, Emilio Di Lorenzo, Michele Portoghese, Christian Pristipino, Renato Pietro Ricci, Sakis Themistoclakis, Luigi Padeletti, Claudio Tondo, Sergio Berti, Jacopo Andrea Oreglia, Gino Gerosa, Marco Zanobini, Gian Paolo Ussia, Giuseppe Musumeci, Francesco Romeo, Roberto Di Bartolomeo
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence is increasing due to the progressive aging of the population. About 20% of strokes are attributable to AF and AF patients are at 5-fold increased risk of stroke. The mainstay of treatment of AF is the prevention of thromboembolic complications with oral anticoagulation therapy. Drug treatment for many years has been based on the use of vitamin K antagonists, but recently newer and safer molecules have been introduced (dabigatran etexilate, rivaroxaban, apixaban and edoxaban)...
July 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27567013/left-atrial-appendage-closure-a-single-center-experience-and-comparison-of-two-contemporary-devices
#18
Filippo Figini, Patrizio Mazzone, Damiano Regazzoli, Giulia Porata, Neil Ruparelia, Francesco Giannini, Stefano Stella, Francesco Ancona, Eustachio Agricola, Nicoleta Sora, Alessandra Marzi, Andrea Aurelio, Nicola Trevisi, Paolo Della Bella, Antonio Colombo, Matteo Montorfano
OBJECTIVES: To compare indications and clinical outcomes of two contemporary left atrial appendage (LAA) percutaneous closure systems in a "real-world" population. BACKGROUND: Percutaneous LAA occlusion is an emerging therapeutic option for stroke prevention in atrial fibrillation. Some questions however remain unanswered, such as the applicability of results of randomized trials to current clinical practice. Moreover, currently available devices have never been directly compared...
August 27, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27529584/first-case-of-percutaneous-left-atrial-appendage-closure-by-amulet%C3%A2-device-in-a-patient-with-left-atrial-appendage-thrombus
#19
Kudret Aytemir, Adel Aminian, Serkan Asil, Uğur Canpolat, Ergün Barış Kaya, Levent Şahiner, Banu Evranos, Hikmet Yorgun, Necla Özer
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27489242/locked-away-percutaneous-closure-of-a-malignant-left-atrial-appendage-to-constrain-an-unresolvable-thrombus
#20
Daniela Dugo, Stefano Bordignon, Athanasios Konstantinou, Laura Perrotta, Alexander Fürnkranz, Julian K R Chun, Boris Schmidt
No abstract text is available yet for this article.
August 2016: Circulation. Arrhythmia and Electrophysiology
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