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Left atrial closure device

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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/27867289/amplatzer-cardiac-plug-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-bigger-left-atrial-appendix-size
#2
Yoga Yuniadi, Dicky A Hanafy, Sunu B Raharjo, Ario Soeryo, IIf Yasmina, Amiliana M Soesanto
Left atrial appendage (LAA) dimensions have been shown as an independent predictor of higher risk for stroke in AF patients. Little data exist on the outcomes after LAA closure in patients with nonvalvular atrial fibrillation (NVAF) who have relatively bigger LAA size. This study aims to evaluate the results associated with LAA closure with the Amplatzer cardiac plug (ACP, AGA, St. Jude Medical, Minneapolis, MN) in bigger LAA size. A total of 25 patients with NVAF underwent LAA closure with the ACP device. All patients received short-term (up to 3 months) dual-antiplatelet therapy (clopidogrel and aspirin) after the procedure and aspirin only thereafter...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27864311/late-dehiscence-of-left-atrial-appendage-closure-device
#3
Santosh K Padala, Parikshit S Sharma, Walter H J Paulsen, Vigneshwar Kasirajan, John D Grizzard, Matthew Sackett, Kenneth A Ellenbogen
No abstract text is available yet for this article.
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#4
REVIEW
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
November 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27862233/transesophageal-echocardiographic-diagnosis-of-a-watchman-left-atrial-appendage-closure-device-thrombus-10%C3%A2-years-following-implantation
#5
Shariq Shamim, Anthony Magalski, Adnan C Chhatriwalla, Keith B Allen, Kenneth C Huber, Michael L Main
Left atrial appendage closure with the WATCHMAN device is an alternative to chronic oral anticoagulation for thromboembolic prophylaxis in atrial fibrillation patients. Left atrial device-related thrombus (DRT) has been described in the first year after implant with an incidence of ~6%. A 79-year-old man underwent WATCHMAN device placement in 2006. Routine protocol specified follow-up transesophageal echocardiograms (TEE) at 6 weeks, 6 months, and 1 year following implant showed no evidence for DRT or peri-device flow...
November 16, 2016: Echocardiography
https://www.readbyqxmd.com/read/27862027/surgical-transapical-approach-for-prosthetic-mitral-paravalvular-leak-closure-early-results
#6
Unal Aydin, Onur Sen, Ersin Kadirogullari, Burak Onan, Aydin Yildirim, Ihsan Bakir
The objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini-thoracotomy. All patients were in NYHA functional class III-IV and median logistic EuroSCORE was 24.2 ± 6...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27860249/left-atrial-appendage-closure-initial-experience-with-the-ultraseal-device
#7
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/27847261/clinically-apparent-long-term-electric-disturbances-in-the-acute-and-very-long-term-of-patent-foramen-ovale-device-based-closure
#8
Gianluca Rigatelli, Marco Zuin, Luigi Pedon, Roberto Zecchel, Fabio Dell'Avvocata, Antonio Carrozza, Marco Zennaro, Gianni Pastore, Francesco Zanon
BACKGROUND/PURPOSE: Incidence of electrical disturbances in patients submitted to transcatheter patent foramen ovale (PFO) closure has not been fully clarified in a large population. The aim of the study is to assess the incidence of atrial fibrillation, supraventricular tachi-arrhythmias, and atrio-ventricular block in the acute and very long-term follow-up. METHODS/MATERIALS: We reviewed the medical and instrumental data of 1000 consecutive patients (mean age 47...
October 29, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27832757/mid-term-results-of-interventional-closure-of-patent-foramen-ovale-with-the-occlutech-figulla-%C3%A2-flex-ii-occluder
#9
Jonas Neuser, Muharrem Akin, Udo Bavendiek, Tibor Kempf, Johann Bauersachs, Julian D Widder
BACKGROUND: Patients with a patent foramen ovale (PFO) who suffered from stroke, TIA or peripheral paradoxical embolism are at substantial risk for recurrent neurologic events and in need for secondary prevention. Interventional closure of PFO has been performed for over 20 years. Numerous devices have been developed and used for treatment. We investigated PFO closure with the third generation Occlutech Figulla(®) Flex II Occluder device. METHODS: Between 2012 and 2015 57 patients (mean age 47...
November 10, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27822906/simultaneous-large-bi-atrial-device-related-thrombi
#10
Jonas Dominik Häner, Christian Seiler
Simultaneous appearance of a pacemaker-lead associated thrombus and a left atrial appendage closure device related thrombus in a patient with urothelial carcinoma shown in a transesophageal echocardiography.
November 7, 2016: Journal of Thrombosis and Thrombolysis
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
#11
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
#12
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/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
#13
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/27771552/use-of-non-warfarin-oral-anticoagulants-instead-of-warfarin-during-left-atrial-appendage-closure-with-the-watchman-device
#14
Yoshinari Enomoto, Varuna K Gadiyaram, Carola Gianni, Rodney P Horton, Chintan Trivedi, Sanghamitra Mohanty, Luigi Di Biase, Amin Al-Ahmad, J David Burkhardt, Arvin Narula, Gwen Janczyk, Matthew J Price, Muhammad R Afzal, Moustapha Atoui, Matthew Earnest, Vijay Swarup, Shephal K Doshi, Sarina van der Zee, Rebecca Fisher, Dhanunjaya R Lakkireddy, Douglas N Gibson, Andrea Natale, Vivek Y Reddy
BACKGROUND: In the stroke prevention trials of left atrial appendage closure with the Watchman device (Boston Scientific), a postimplantation antithrombotic regimen of 6 weeks of warfarin was used. OBJECTIVE: Given the clinical complexity of warfarin use, the purpose of this study was to study the relative feasibility and safety of using non-warfarin oral anticoagulants (NOACs) instead of warfarin during the peri- and initial postimplantation periods after Watchman implantation...
October 19, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27745964/characterization-of-cerebrovascular-events-after-left-atrial-appendage-occlusion
#15
Xavier Freixa, Laura Llull, Sameer Gafoor, Ignacio Cruz-Gonzalez, Samera Shakir, Heyder Omran, Sergio Berti, Gennaro Santoro, Joelle Kefer, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Prapa Kanagaratnam, Fabian Nietlispach, Steffen Gloekler, Adel Aminian, Paolo Danna, Marco Rezzaghi, Friederike Stock, Miroslava Stolcova, Luis Paiva, Marco Costa, Xavier Millán, Reda Ibrahim, Tobias Tichelbäcker, Wolfgang Schillinger, Jai-Wun Park, Horst Sievert, Bernhard Meier, Apostolos Tzikas
Cardioembolic strokes are generally more lethal and disabling than other source of strokes. Data from PROTECT AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in Patients With Atrial Fibrillation) suggest that strokes after left atrial appendage occlusion (LAAO) with the Watchman device are less disabling than those in the warfarin group. No data assessing the severity of strokes after LAAO with the AMPLATZER Cardiac Plug (ACP) are available. The objective of the study was to evaluate the severity of cerebrovascular events after LAAO with the ACP in a population mostly characterized by an absolute or relative contraindication to oral anticoagulation...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27706224/comparison-of-approaches-for-stroke-prophylaxis-in-patients-with-non-valvular-atrial-fibrillation-network-meta-analyses-of-randomized-controlled-trials
#16
Navkaranbir S Bajaj, Rajat Kalra, Nirav Patel, Taimoor Hashim, Hemant Godara, Sameer Ather, Garima Arora, Tilak Pasala, Thomas T Whitfield, David C McGiffin, Mustafa I Ahmed, Steven G Lloyd, Nita A Limdi, Pankaj Arora
BACKGROUND: Multiple novel oral anticoagulants and left atrial appendage closure devices (WATCHMAN) have been tested against dose-adjusted vitamin K antagonists in randomized controlled trials for stroke prophylaxis in non-valvular atrial fibrillation. No direct comparisons of these strategies are available from randomized controlled trials. We conducted the current analyses by combining efficacy and safety characteristics of all FDA approved stroke prophylaxis treatment strategies for patients with non-valvular atrial fibrillation...
2016: PloS One
https://www.readbyqxmd.com/read/27702856/atrial-arrhythmia-after-transcatheter-closure-of-secundum-atrial-septal-defects-in-patients-%C3%A2-40-years-of-age
#17
Phuoc Duong, Lee Patrick Ferguson, Stephen Lord, Stephen Murray, Ewen Shepherd, John Pius Bourke, David Crossland, John O'Sullivan
AIM: Data on arrhythmia outcome following device closure of atrial septal defect (ASD) are lacking. This study provides medium-term follow-up data on atrial arrhythmias in patients who were ≥40 years of age at the time of transcatheter ASD closure. METHODS AND RESULTS: It is a retrospective review. Mean age of the 159 patients was 57 years. Median follow-up was 3.6 years (range 6 months-10.9 years). Patients were classified, according to arrhythmia status prior to ASD closure, into Group I, no history of atrial arrhythmia (n = 119, mean age 55...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27696317/left-atrial-appendage-closure-for-stroke-prevention-in-atrial-fibrillation
#18
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
#19
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/27680664/left-atrial-appendage-closure-under-intracardiac-echocardiographic-guidance-feasibility-and-comparison-with-transesophageal-echocardiography
#20
Yae Matsuo, Petr Neuzil, Jan Petru, Milan Chovanec, Marek Janotka, Subbarao Choudry, Jan Skoda, Lucie Sediva, Masahiko Kurabayashi, Vivek Y Reddy
BACKGROUND: Transcatheter left atrial appendage closure is an alternative therapy for stroke prevention in atrial fibrillation patients. These procedures are currently guided with transesophageal echocardiography and fluoroscopy in most centers. As intracardiac echocardiography (ICE) is commonly used in other catheter-based procedures, we sought to determine the safety and effectiveness of intracardiac echocardiography-guided left atrial appendage closure with the Watchman device. METHODS AND RESULTS: A total of 27 patients (11 males, 77...
September 28, 2016: Journal of the American Heart Association
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