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percutaneous left atrial appendage closure

Lim Eng, Jacqueline Saw
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
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
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
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
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
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
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
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
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
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
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
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
Jakob Ledwoch, Christine Krollmann, Stephan Staubach, Martin Hug, Henning Strohm, Harald Mudra
OBJECTIVES: We sought to evaluate the effect of increasing experience with left atrial appendage (LAA) closure on short-term outcome. BACKGROUND: Data regarding the impact of the learning curve of LAA closure-particularly regarding technical aspects of the procedure-are lacking. METHODS: The present analysis represents first data from a single-center all-comer registry. The population was divided into 3 groups according to treatment time (group 1: patients 1-30; group 2: patients 31-60; group 3: patients 61-90)...
August 2016: Journal of Interventional Cardiology
Mathias Wolfrum, Adrian Attinger-Toller, Samera Shakir, Steffen Gloekler, Burkhardt Seifert, Aris Moschovitis, Ahmed Khattab, Francesco Maisano, Bernhard Meier, Fabian Nietlispach
OBJECTIVE: The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. BACKGROUND: The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. METHODS: Outcomes of 169 consecutive patients (age 73...
July 28, 2016: Catheterization and Cardiovascular Interventions
Arash Aryana, André d'Avila
Incomplete left atrial appendage closure (LAAC) occurs in ∼30-40 % of cases following both surgical and percutaneous closure methods. Incomplete surgical LAAC may further be classified as incompletely surgically ligated LAA (ISLL) or LAA stump. ISLL is associated with a significantly increased risk of thrombus formation/thromboembolism. Moreover, this risk is highest in the absence of oral anticoagulation (OAC) and inversely correlates with the size of the ISLL neck. Not only routine screening for ISLL seems critical, but also long-term OAC should strongly be considered in this high-risk cohort...
September 2016: Current Cardiology Reports
Jacqueline Saw, Maria C Bennell, Sheldon M Singh, Harindra C Wijeysundera
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is increasingly performed as an alternative to oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (AF). We sought to evaluate the cost-effectiveness of treating OAC contraindicated patients with LAAC compared with aspirin alone. METHODS: A probabilistic patient-level Markov microsimulation model with a lifetime horizon was performed to assess the discounted lifetime costs, quality-adjusted life years, and incremental cost-effectiveness ratio of LAAC compared with aspirin for patients with AF with contraindications to OAC...
February 23, 2016: Canadian Journal of Cardiology
Gaetano Fassini, Sergio Conti, Massimo Moltrasio, Anna Maltagliati, Fabrizio Tundo, Stefania Riva, Antonio Dello Russo, Michela Casella, Benedetta Majocchi, Martina Zucchetti, Eleonora Russo, Vittoria Marino, Mauro Pepi, Claudio Tondo
AIMS: Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy. METHODS AND RESULTS: Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation...
July 11, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Zakaria Jalal, Xavier Iriart, Marie-Lou Dinet, Jean-Bernard Selly, Nadir Tafer, Pauline Renou, Igor Sibon, Jean-Benoît Thambo
BACKGROUND: Percutaneous left atrial appendage (LAA) closure has emerged as an alternative therapeutic option for the prevention of embolic stroke in high-risk patients with non-valvular atrial fibrillation. The presence of thrombus in the LAA is currently a contraindication to the procedure. AIM: To describe a modified LAA closure technique that allows a safe procedure in patients with LAA thrombus. METHODS: Between May 2013 and October 2014, LAA closure was performed in three patients with LAA thrombus (mean age 73...
July 8, 2016: Archives of Cardiovascular Diseases
Konstantinos C Koskinas, Samera Shakir, Máté Fankhauser, Fabian Nietlispach, Adrian Attinger-Toller, Aris Moschovitis, Peter Wenaweser, Thomas Pilgrim, Stefan Stortecky, Fabien Praz, Lorenz Räber, Stephan Windecker, Bernhard Meier, Steffen Gloekler
OBJECTIVES: The aim of this study was to assess predictors of adverse 1-week outcomes and determine the effect of left atrial appendage (LAA) morphology following LAA closure (LAAC) with Amplatzer devices. BACKGROUND: Percutaneous LAAC is a valuable treatment option for stroke prevention in patients with atrial fibrillation. Determinants of procedural safety events with Amplatzer occluders are not well established, and the possibly interrelating effect of LAA anatomy is unknown...
July 11, 2016: JACC. Cardiovascular Interventions
Antonio Rodríguez Fernández, Armando Bethencourt González
Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a systematic assessment of atrial septum anatomy, locating and measuring the size and shape of all defects, their rims, and the degree and direction of shunting...
August 2016: Revista Española de Cardiología
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