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Left atrial closure device

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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
#1
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/28411903/left-atrial-appendage-closure-device-in-atrial-fibrillation
#2
REVIEW
Michael C Giudici, Prashant D Bhave
The relationship of stroke and atrial fibrillation seems to become more complex as we gain more knowledge of the issue. Recent studies have questioned the temporal relationship between the two, which also questions causation. Left atrial appendage closure is an attractive, but unproven technology when compared with the 50-year experience with warfarin. In a patient who is on warfarin and having no issues with bleeding, medication intolerance, or lack of efficacy, it is difficult to justify stopping the drug and placing a closure device as sole therapy to prevent a stroke...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28398383/-right-atrial-appendage-thrombosis-during-atrial-fibrillation-an-element-to-look-for
#3
Giovanni Barbati, Renato De Domenico, Stefania Rossi, Elena Vecchiato, Roberto Zeppellini
Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28383438/safety-and-efficacy-of-cardi-o-fix-occluder-for-percutaneous-closure-of-a-patent-foramen-ovale-a-single-center-prospective-study
#4
Enfa Zhao, Wenjuan Liu, Yushun Zhang, Gesheng Cheng, Yajuan Du, Lu He, Xingye Wang, Xumei He
BACKGROUND: Amplatzer occluder and Cardio-O-fix occluder are currently used in percutaneous closure of patent foramen ovale. However, there is still a lack of relevant reports comparison the differences between them. The aim of this study was to evaluate the short-term and mid-term safety and efficacy of the Cardi-O-fix occluder in preventing recurrent cerebrovascular events in patients with a patent foramen ovale (PFO). METHODS: We enrolled 246 patients (105 men) with a PFO from May 30, 2013 to March 30, 2015 in this single-center prospective study...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28382270/delayed-left-atrial-perforation-associated-with-erosion-after-device-closure-of-an-atrial-septal-defect
#5
Ji Seong Kim, Sang Yoon Yeom, Sue Hyun Kim, Jae Woong Choi, Kyung Hwan Kim
A 43-year-old man who had had a history of atrial septal defect (ASD) device closure 31 months previously presented with abrupt chest and back pain along with progressive cardiogenic shock and cardiac arrest. After resuscitation, he was diagnosed with cardiac tamponade. Diagnostic and therapeutic surgical exploration revealed left atrium (LA) perforation due to LA roof erosion from a deficient aortic rim. Device removal, primary repair of the LA perforation site, and ASD patch closure were performed successfully...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28382081/changes-in-strain-pattern-and-exercise-capacity-after-transcatheter-closure-of-atrial-septal-defects
#6
Jung Yoon Kim, Bong-Sic Yun, Sunho Lee, Se Yong Jung, Jae Young Choi, Nam Kyun Kim
BACKGROUND AND OBJECTIVES: Assessment of left ventricle (LV) function by using strain and strain rate is popular in the clinical setting. However, the use of these echocardiographic tools in assessing right ventricle (RV) failure, and the manner in which they both reflect the functional capacity of the patient, remains poorly understood. This study aimed to investigate the change in exercise capacity and strain between before and (1 month) after the transcatheter closure of atrial septal defects (ASDs)...
March 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28369643/epicardial-clip-occlusion-of-the-left-atrial-appendage-during-cardiac-surgery-provides-optimal-surgical-results-and-long-term-stability%C3%A2
#7
Vojtech Kurfirst, Aleš Mokrácek, Júlia Canádyová, Radim Frána, Petr Zeman
OBJECTIVES: Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures. METHODS: A total of 101 patients (average age 65...
March 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28369344/first-endocardial-rotor-ablation-using-a-64-pole-basket-catheter-in-a-patient-with-a-left-atrial-appendage-closure-device
#8
Barbara Bellmann, Mario Kasner, Ulf Landmesser, Andreas Rillig
No abstract text is available yet for this article.
March 21, 2017: European 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
#9
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/28359494/migration-of-an-atrial-septal-occluder-device-with-formation-of-abdominal-aortic-dissection
#10
Serkan Burç Deşer, Mustafa Kemal Demirağ
Atrial septal defects can be closed surgically or percutaneously. However, percutaneous closure of atrial septal defects carries some risks. Embolization of the atrial septal occluder is the major adverse event. Embolization of the device into the main pulmonary artery, left atrium, right ventricle, aortic arch, descending aorta, abdominal aorta, iliac bifurcation, and iliac arteries can be seen. We report the case of a 19-year-old man with migration of an Amplatzer (St Jude Medical, St Paul, MN) atrial septal occluder into the iliac bifurcation with the development of abdominal aortic dissection 1 month after successful percutaneous closure...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28345270/false-positive-retroaortic-left-circumflex-coronary-artery-in-a-patient-with-atrial-septal-defect
#11
Saurabh Kumar Gupta, Anunay Gupta, Sivasubramanian Ramakrishnan, Shyam S Kothari
Retroaortic course of coronary artery is a relative contraindication for device closure of an atrial septal defect. In this brief report, we demonstrate, for the first time, inferior aortic recess mimicking retroaortic left circumflex coronary artery in a patient with atrial septal defect. This distinction is important to avoid spurious diagnosis of anomalous coronary artery denying patient a chance of nonsurgical closure of atrial septal defect.
March 27, 2017: Echocardiography
https://www.readbyqxmd.com/read/28341764/transesophageal-echocardiographic-guidance-of-transcatheter-closure-of-the-aortic-valve-in-a-patient-with-left-ventricular-assist-device-related-severe-aortic-regurgitation
#12
Preetham Muskala, Taiyeb M Khumri, Michael L Main
A 68 year-old man with a severe ischemic cardiomyopathy underwent left ventricular assist device (LVAD) implantation (Heart Mate II device) for destination therapy. He presented 49 months following LVAD implant with worsening heart failure symptoms and new severe aortic regurgitation. Given high risk for both surgical and transcatheter aortic valve replacement, he was admitted for transcatheter closure of the aortic valve under transesophageal echocardiographic (TEE) guidance. TEE imaging revealed severe aortic regurgitation (see Figure 1A and 1B, and multimedia files 1 and 2)...
March 24, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28293114/novel-stroke-risk-reduction-in-atrial-fibrillation-left-atrial-appendage-occlusion-with-a-focus-on-the-watchman-closure-device
#13
REVIEW
Arash Alipour, Lisette I S Wintgens, Martin J Swaans, Jippe C Balt, Benno J W M Rensing, Lucas V A Boersma
Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS2 or CHA2DS2-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28289527/left-atrial-appendage-occlusion-a-better-alternative-to-anticoagulation
#14
REVIEW
Ibrahim Akin, Christoph A Nienaber
Non-valvular atrial fibrillation is associated with a significantly increased risk of embolic stroke due to blood clot forming predominantly in the left atrial appendage (LAA). Preventive measures to avoid embolic events are permanent administration of anticoagulants or surgical closure of the LAA. Various clinical trials provide evidence about safety, effectiveness and therapeutic success of LAA occlusion using various cardiac occluder devices. The use of such implants for interventional closure of the LAA is likely to become a valuable alternative for stroke prevention, especially in patients with contraindication for oral anticoagulation as safety, clinical benefit and cost-effectiveness of LAA occlusion has recently been demonstrated...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28281734/percutaneous-left-atrial-appendage-occlusion-new-perspectives-for-the-method
#15
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/28281414/reversal-of-severe-mitral-regurgitation-by-device-closure-of-a-large-patent-ductus-arteriosus-in-a-premature-infant
#16
Ahmed Kheiwa, Robert D Ross, Daisuke Kobayashi
We report a critically ill premature infant with severe mitral valve regurgitation associated with pulmonary hypertension and a severely dilated left atrium from a large patent ductus arteriosus. The mitral valve regurgitation improved significantly with normalisation of left atrial size 4 weeks after percutaneous closure of the patent ductus arteriosus. This case highlights the potential reversibility of severe mitral valve regurgitation with treatment of an underlying cardiac shunt.
January 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28243428/non-pharmacologic-approach-to-prevent-embolization-in-patients-with-atrial-fibrillation-in-whom-anticoagulation-is-contraindicated
#17
Munish Sharma, Koroush Khalighi
Ischemic stroke is the most common complication of atrial fibrillation (AF). Anticoagulation therapy reduces the risk of systemic embolization in almost all patients with AF irrespective of the type of AF (paroxysmal, persistent or permanent). But, all patients are not suitable candidates for systemic anticoagulation mainly due to the risk of bleeding. Left atrial appendage closure (LAAC) devices have been found to be very effective non-pharmacologic alternative therapy for such patients. There are various types of LAAC devices but United States Food and Drug Administration (US-FDA) have approved only Watchman device...
January 11, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#18
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
February 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28149625/five-years-of-keeping-a-watch-on-the-left-atrial-appendage-how-has-the-watchman-fared
#19
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/28129320/totally-endoscopic-robotic-left-atrial-appendage-closure-demonstrates-high-success-rate
#20
Alison F Ward, Robert M Applebaum, Nana Toyoda, Ans Fakiha, Peter J Neuburger, Jennie Ngai, Robert G Nampiaparampil, David W Yaffee, Didier F Loulmet, Eugene A Grossi
OBJECTIVE: In patients with atrial fibrillation, 90% of embolic strokes originate from the left atrial appendage (LAA). Successful exclusion of the LAA is associated with a lower stroke rate in patients with atrial fibrillation. Surgical oversewing of the LAA is often incomplete when evaluated with transesophageal echocardiogram (TEE). External closure techniques of suturing and stapling have also demonstrated high failure rates with persistent flow and large stumps. We hypothesized that the precise visualization of a robotic LAA closure (RLAAC) would result in superior closure rates...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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