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Left atrial appendage occlusion

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https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#1
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28714617/-left-atrial-appendage-occlusion-for-atrial-fibrillation
#2
Marco Roberto, Amir-Ali Fassa, Edoardo De Benedetti
Embolic stroke is the most dangerous complication of atrial fibrillation (AF). Oral anticoagulation represents the treatment of choice for thromboembolic (TE) prophylaxis in patients with a CHADS2VASc score ≥ 1 but is associated with a significant increase in haemorrhagic events. Almost 90 % of thrombi originate in the left atrial appendage. Registries have shown that percutaneous occlusion of this appendage reduces embolic risk and may be considered for TE prophylaxis in patients with a high TE (CHADS2VASc score ≥ 2) and haemorrhagic (HAS-BLED score ≥ 3) risk...
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28691914/residual-leaks-following-percutaneous-left-atrial-appendage-occlusion-assessment-and-management-implications
#3
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/28690086/combined-mitraclip-implantation-and-left-atrial-appendage-occlusion-because-it-s-there-revisited
#4
Duarte Cacela
No abstract text is available yet for this article.
July 6, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28675629/long-term-follow-up-after-left-atrial-appendage-occlusion-with-comparison-of-transesophageal-echocardiography-vs-computed-tomography-to-guide-medical-therapy-and-data-about-post-closure-cardioversion
#5
Benjamin Berte, Christine Attenhofer Jost, Dominik Maurer, Anja Fäh-Gunz, Xavier Pillois, Barbara Naegeli, Monica Pfyffer, Gabor Sütsch, Christoph Scharf
AIMS: The use of left atrial appendage (LAA)-occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice-flow and outcome of electrical cardioversion (ECV) in these patients. METHODS AND RESULTS: Single-center prospective registry from 2009 to 2015 including all LAA-occluders to analyze success and complications during implantation and follow-up...
July 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28673783/combined-mitraclip-implantation-and-left-atrial-appendage-occlusion-using-the-watchman-device-a-case-series-from-a-referral-center
#6
Ana Rita G Francisco, Eduardo Infante de Oliveira, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Pedro Canas da Silva, Ângelo Nobre, Fausto J Pinto
INTRODUCTION: Patients referred for percutaneous transcatheter mitral valve repair using the MitraClip(®) system frequently have atrial fibrillation, which imposes additional challenges due to the need for oral anticoagulation. Left atrial appendage occlusion is currently regarded as a non-inferior alternative to anticoagulation in patients with non-valvular atrial fibrillation and both high thromboembolic and bleeding risk. Considering that both MitraClip implantation and left atrial appendage occlusion are percutaneous techniques that require transseptal puncture, it is technically attractive to consider their concomitant use...
June 30, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28667807/improved-algorithm-for-ostium-size-assessment-in-watchman-left-atrial-appendage-occlusion-using-three-dimensional-echocardiography
#7
Maximilian Schmidt-Salzmann, Felix Meincke, Felix Kreidel, Tobias Spangenberg, Alexander Ghanem, Karl-Heinz Kuck, Martin W Bergmann
AIMS: Correct sizing of the ostium is a crucial step in left atrial appendage (LAA) occlusion procedures. However, unfavorable anatomy of the ostium often complicates the assessment of the true ostium diameter. We hypothesized that area-derived diameter (ADD) and perimeter-derived diameter (PDD) from three-dimensional transesophageal echocardiogram (3D-TEE) can facilitate this step of the procedure as compared with two-dimensional (2D) measurements. METHODS AND RESULTS: For 55 patients within the ALSTER-LAA registry, retrospective analysis of PDD and ADD was correlated with 2D measurements used during the procedure to ascertain correct size of the Watchman device (Boston Scientific)...
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28652126/patient-specific-3d-printed-cardiac-model-for-percutaneous-left-atrial-appendage-occlusion
#8
Beatriz Vaquerizo, Carmen Escabias, Daniela Dubois, Gorka Gómez, Manuel Barreiro-Pérez, Ignacio Cruz-González
No abstract text is available yet for this article.
June 23, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28652029/dealing-with-the-left-atrial-appendage-for-stroke-prevention-devices-and-decision-making
#9
REVIEW
Karen P Phillips, Vince Paul
Left atrial appendage (LAA) device occlusion represents a major evolution in stroke prevention for atrial fibrillation (AF). Left atrial appendage device occlusion is now a proven strategy which provides long-term thromboembolic stroke prevention for patients with non-rheumatic AF. Evidence supports its benefit as an alternative to long-term anticoagulation while mitigating long-term bleeding risks and improving cardiovascular mortality. The therapy offers expanded options to physicians and patients negotiating stroke prevention (both primary and secondary prevention), but a good understanding of the risks and benefits is required for decision-making...
May 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28649053/left-atrial-appendage-occlusion-with-the-amplatzer-amulet-device-periprocedural-and-early-clinical-echocardiographic-data-from-a-global-prospective-observational-study
#10
Ulf Landmesser, Boris Schmidt, Jens Erik Nielsen-Kudsk, Simon Cheung Chi Lam, Jai-Wun Park, Giuseppe Tarantini, Ignacio Cruz-Gonzalez, Volker Geist, Paolo Della Bella, Antonio Colombo, Tobias Zeus, Heyder Omran, Christopher Piorkowski, Juha Lund, Claudio Tondo, David Hildick-Smith
AIMS: The global, prospective AMPLATZER Amulet observational study documents real-world periprocedural, transoesophageal echocardiographic (TEE) and clinical outcomes from left atrial appendage occlusion (LAAO) using the AMPLATZER Amulet device. The aim of this report is to describe the periprocedural and early clinical/TEE results from this study. METHODS AND RESULTS: This multicentre prospective real-world registry included 1,088 patients (75±8.5 years, 64.5% male, CHA2DS2-VASc: 4...
June 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#11
Zeena Husain, Payam Safavi-Naeini, Abdi Rasekh, Mehdi Razavi, Charles D Collard, James M Anton, Daniel A Tolpin
Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation. Unfortunately, despite optimal medical management, thromboembolic events still occur. Recently, there has been a great deal of interest and innovation in finding an alternative to chronic anticoagulation...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#12
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28612910/percutaneous-left-atrial-appendage-occlusion-procedures-in-patients-with-heart-failure
#13
Magdalena Szymała, Witold Streb, Katarzyna Mitręga, Tomasz Podolecki, Grzegorz Mencel, Tomasz Kukulski, Zbigniew Kalarus
BACKGROUND: Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia. The percutaneous left atrial appendage occlusion (LAAO) may be considered for the stroke prophylaxis in patients with nonvalvular AF (NVAF), especially in contraindications for oral anticoagulants (OAC) or high risk of bleeding. The data about implantation, safety, efficacy and follow-up are limited. Moreover, there are no studies on patients with NVAF and heart failure with severe left ventricular systolic dysfunction (left ventricular ejection fraction - LVEF ≤ 35%)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28595859/left-atrial-appendage-occlusion-in-patients-with-atrial-fibrillation-and-previous-major-gastrointestinal-bleeding-from-the-amplatzer-cardiac-plug-multicenter-registry
#14
Mathieu Lempereur, Adel Aminian, Xavier Freixa, Sameer Gafoor, Samera Shakir, Heyder Omran, Sergio Berti, Gennaro Santoro, Joelle Kefer, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Ignacio Cruz-Gonzalez, Prapa Kanagaratnam, Fabian Nietlispach, Reda Ibrahim, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Steffen Gloekler, Apostolos Tzikas
History of major gastrointestinal (GI) bleeding may represent a frequent clinical indication for left atrial appendage occlusion (LAAO) in patients with non-valvular atrial fibrillation (AF). This study aims to investigate the procedural safety and long-term outcome of patients with previous major GI bleeding (MGIB) who underwent LAAO. Data from the Amplatzer Cardiac Plug multicenter registry on 1,047 patients were analyzed. Patients with previous MGIB as indication for LAAO were compared with patients without previous MGIB...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28591860/suggestions-for-clinical-studies-on-percutaneous-left-atrial-appendage-occlusion-authors-reply
#15
Apostolos Tzikas, David R Holmes, Dhanunjaya Lakkireddy, A John Camm, Thorsten Lewalter
No abstract text is available yet for this article.
June 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28580563/-new-treatment-for-vascular-thrombosis-prevention-in-patients-with-atrial-fibrillation-left-atrial-appendage-occlusion
#16
Chen-Wei Lin, Shiao-Pei Wang
Atrial fibrillation (AF) is a common type of arrhythmia that increases significantly the risk of blood clots in the heart and of stroke. Therefore, stroke prevention is a key goal of AF treatment. In the past, patients were required to take anticoagulants for the remainder of their life, to regularly the monitor international normalized ratio (INR) of prothrombin time (PT), and to avoid possible negative interactions with various drugs and foods. Left atrial appendage occlusion (LAAO), a novel device and technique, was thus developed for AF patients with contraindications to anticoagulants and a high risk of bleeding...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28577840/efficacy-and-safety-of-left-atrial-appendage-closure-with-watchman-in-patients-with-or-without-contraindication-to-oral-anticoagulation-1-year-follow-up-outcome-data-of-the-ewolution-trial
#17
Lucas V Boersma, Hueseyin Ince, Stephan Kische, Evgeny Pokushalov, Thomas Schmitz, Boris Schmidt, Tommaso Gori, Felix Meincke, Alexey Vladimir Protopopov, Timothy Betts, David Foley, Horst Sievert, Patrizio Mazzone, Tom De Potter, Elisa Vireca, Kenneth Stein, Martin W Bergmann
BACKGROUND: Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. OBJECTIVE: EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry. METHODS: A total of 1025 patients scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers. Indication for LAA closure was based on European Society of Cardiology guidelines...
May 31, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28565887/safety-and-efficacy-of-catheter-based-left-atrial-appendage-closure-in-patients-with-contraindications-for-long-term-anticoagulation
#18
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/28558866/potential-clinical-utility-and-feasibility-of-combined-left-atrial-appendage-closure-and-positioning-of-miniaturized-pacemaker-through-a-single-right-femoral-vein-access
#19
François Regoli, Marco Araco, Tiziano Moccetti, Maria Luce Caputo, Giulio Conte, Angelo Auricchio, Marco Moccetti
This study assessed the clinical utility and feasibility of concomitant of combined left atrial appendage (LAA) closure and positioning of miniaturized pacemaker (Micra TPS). All consecutive patients who underwent VVI-PM implant from November 2015 to October 2016 were considered. VVI-PM implant was conducted either using transvenous approach or by positioning Micra TPS. In selected patients with concomitant contraindication to OAC, Micra TPS was combined with LAA occlusion ("combined approach"), performed in general anesthesia and guided by multimodality imaging; procedural and follow-up data of these specific patients were registered...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28546017/delayed-left-atrial-appendage-contrast-filling-in-computed-tomograms-after-percutaneous-left-atrial-appendage-occlusion
#20
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
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