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percutaneous left atrial appendage closure

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https://www.readbyqxmd.com/read/28281734/percutaneous-left-atrial-appendage-occlusion-new-perspectives-for-the-method
#1
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
#2
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
#3
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
#4
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...
February 8, 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
#5
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-multi-center-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#6
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/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
#7
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...
January 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28073645/percutaneous-closure-of-a-whale-tail-left-atrial-appendage
#8
Xavier Freixa, Alejandro Panaro, Julio Carballo
No abstract text is available yet for this article.
January 7, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28065447/percutaneous-left-atrial-appendage-closure-followed-by-single-antiplatelet-therapy-short-and-mid-term-outcomes
#9
Zakaria Jalal, Marie-Lou Dinet, Nicolas Combes, Xavier Pillois, Pauline Renou, Igor Sibon, Xavier Iriart, Jean-Benoît Thambo
BACKGROUND: After left atrial appendage closure (LAAC), various antithrombotic protocols have been suggested, but the optimal post-procedural antithrombotic strategy is still under debate. AIMS: To investigate the efficacy and safety of LAAC with an AMPLATZER™ Cardiac Plug (ACP) device (St. Jude Medical, Minneapolis, MN, USA) followed by single antiplatelet therapy. METHODS: Consecutive patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulants who underwent LAAC with an ACP device between 2012 and 2014 in two French centres were included...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28041899/left-atrial-appendage-closure-in-patients-with-atrial-fibrillation-and-previous-intracerebral-hemorrhage
#10
Pauline Renou, Jean-Benoît Thambo, Xavier Iriart, Stéphanie Nicot, Nathanael Kabore, Zakaria Jalal, Stéphane Olindo, Sabrina Debruxelles, Mathilde Poli, François Rouanet, Igor Sibon
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) may be considered in patients with atrial fibrillation and contraindication for long-term anticoagulation. This study aimed to assess the safety and efficacy of LAAC followed by single antiplatelet therapy in patients with atrial fibrillation and previous spontaneous intracerebral hemorrhage (ICH). METHODS: In this explorative, prospective, single-center study, consecutive patients who underwent LAAC because of previous spontaneous ICH over a period of 4 years were analyzed...
December 30, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28013284/ct-sizing-for-left-atrial-appendage-closure-is-associated-with-favourable-outcomes-for-procedural-safety
#11
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/28011105/a-guide-to-transseptal-access
#12
Enes E Gul, Adrian Baranchuk, Benedict M Glover
Transseptal access is commonly performed for any procedure that requires access to the left side of the heart such as catheter ablation of atrial fibrillation, left atrial tachycardia, left-sided accessory pathways, ventricular tachycardia, left atrial appendage closure, percutaneous mitral valvuloplasty, and mitral valve repair. To perform this in a safe and effective manner it is important that the operator has a detailed knowledge of the relevant anatomy, the technique required, and the ability to deal with difficult cases and complications...
October 21, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28001014/stroke-prevention-in-atrial-fibrillation-with-left-atrial-appendage-closure
#13
Chad J Zack, Erin A Fender, David R Holmes
Patients with atrial fibrillation (AF) are at risk for stroke and thromboembolism. Oral anticoagulants (OAC) are effective therapies to reduce the risk of stroke; however these agents also increase the risk of bleeding complications. Concerns over bleeding contribute to significant under treatment and leave a substantial proportion of patients at risk for a serious or life-threatening stroke. Identification of the left atrial appendage (LAA) as the major site of pathogenic thrombus formation in AF patients has led to the development of devices which exclude the appendage from systemic circulation...
December 20, 2016: Minerva Medica
https://www.readbyqxmd.com/read/27995471/percutaneous-closure-of-a%C3%A2-left-atrial-appendage-with-relevant-suture-dehiscence
#14
L Kleinebrecht, V Veulemans, A Polzin, M Kelm, T Zeus
Atrial fibrillation is a widespread disease and highly relevant as it carries an extended risk for ischaemic stroke. Surgical closure of the left atrial appendage is routinely performed during open heart surgery in patients with atrial fibrillation with the aim of thromboembolic protection. In this report we present a successful percutaneous closure of a left atrial appendage, which showed clinically relevant suture dehiscence several years after surgical closure.
February 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27979034/interventional-left-atrial-appendage-closure-vs-novel-anticoagulation-agents-in-patients-with-atrial-fibrillation-indicated-for-long-term-anticoagulation-prague-17-study
#15
Pavel Osmancik, Petr Tousek, Dalibor Herman, Petr Neuzil, Pavel Hala, Josef Stasek, Ludek Haman, Petr Kala, Martin Poloczek, Marian Branny, Jan Chovancik, Pavel Cervinka, Jiri Holy, Vlastimil Vancura, Richard Rokyta, Milos Taborsky, Tomas Kovarnik, David Zemanek, Petr Peichl, Sarka Haskova, Jiri Jarkovsky, Petr Widimsky
Atrial fibrillation (AF), with a prevalence of 1% to 2%, is the most common cardiac arrhythmia. Without antithrombotic treatment, the annual risk of a cardioembolic event is 5% to 6%. The source of a cardioembolic event is a thrombus, which is usually formed in the left atrial appendage (LAA). Prevention of cardioembolic events involves treatment with anticoagulant drugs: either vitamin K antagonists or, recently, novel oral anticoagulants (NOAC). The other (nonpharmacologic) option for the prevention of a cardioembolic event involves interventional occlusion of the LAA...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27925332/left-atrial-appendage-closure-with-the-new-occlutech%C3%A2-device-first-in-man-experience-and-neurological-outcome
#16
Barbara Bellmann, Steffen Schnupp, Peter Kühnlein, Christian Javernik, Caroline Kleinecke, Andreas Rillig, Ulf Landmesser, Johannes Brachmann, Jai-Wun Park
AIMS: Percutaneous left atrial appendage closure (LAAC) is a valuable treatment option for stroke prevention in patients with atrial fibrillation and a HAS-BLED-Score ≥3. Determinants of procedural safety events and neurological outcome of the patients with the Occlutech device (OD) are not established yet. METHODS AND RESULTS: Between 2012 and 2016, 30 patients underwent LAAC using the OD. This is a prospective study. Neurological examination and transesophageal echocardiography was performed directly before and after the procedure and after 1, 3, and 12 months...
December 7, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27898435/percutaneous-left-atrial-appendage-closure-current-state-of-the-art
#17
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
#18
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-treatment-of-persistent-atrial-fibrillation
#19
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 (CFAEs), linear lesions, and/or isolation of the left atrial appendage (LAA) are thought to improve arrhythmia-free survival. OBJECTIVE: The purpose of this study was to assess the durability of wide-area left atrial appendage 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
#20
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
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