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Left atrial closure device

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https://www.readbyqxmd.com/read/29453694/percutaneous-left-atrial-appendage-occlusion-in-the-prevention-of-stroke-in-atrial-fibrillation-a-systematic-review
#1
REVIEW
Jayson R Baman, Moussa Mansour, E Kevin Heist, David T Huang, Yitschak Biton
Atrial fibrillation is commonly coexistent with heart failure, and the management of the heart failure patient would be incomplete without an appreciation for atrial fibrillation management. There are many complications associated with oral anticoagulation in the prevention of stroke related to atrial fibrillation. In recent years, the advent of several percutaneous left atrial appendage (LAA) occlusion/closure strategies has sought to provide an alternative treatment modality. Here, we systematically review the published literature to investigate the efficacy and safety of percutaneous LAA occlusion/closure devices...
February 17, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29421004/variation-in-practice-patterns-in-device-closure-of-atrial-septal-defects-and-patent-ductus-arteriosus-an-analysis-of-data-from-the-improving-pediatric-and-adult-congenital-treatment-impact-registry
#2
Michael L O'Byrne, Kevin F Kennedy, Jonathan J Rome, Andrew C Glatz
Practice variation is a potentially important measure of healthcare quality. The IMPACT registry provides a representative national sample with which to study practice variation in trans-catheter interventions for congenital heart disease. METHODS: We studied cases for closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) in IMPACT between January 1, 2011, and September 30, 2015, using hierarchical multivariate models studying (1) the distribution of indications for closure and (2) in patients whose indication for closure was left (LVVO) or right ventricular volume overload (RVVO), the factors influencing probability of closure of a small defect (either in size or in terms of the magnitude of shunt)...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29420720/whale-tail-left-atrial-appendage-anatomy-implications-for-percutaneous-closure-devices
#3
Mohamad Alkhouli, David M Campsey, Bryan Raybuck, James Mills
No abstract text is available yet for this article.
February 6, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29411147/atrial-fibrillation-for-the-neurologist-preventing-both-ischemic-and-hemorrhagic-strokes
#4
REVIEW
Elif Gokcal, Marco Pasi, Marc Fisher, M Edip Gurol
PURPOSE OF REVIEW: This review aims to help neurologists managing atrial fibrillation (AF) patients who had an ischemic stroke and/or with intracranial hemorrhage (ICH) markers, therefore at high embolic/hemorrhagic risks. RECENT FINDINGS: Implantable loop recorders have substantially improved the accuracy of AF detection. Recent research yielded a set of powerful neuroimaging markers that can stratify ICH risk. Direct oral anticoagulants (DOAC) are easier to use with a lower ICH risk than warfarin in a general AF population...
February 6, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29404367/paradoxical-emboli-following-a-pulmonary-embolus-in-the-presence-of-a-patent-foramen-ovale
#5
Khalid Najib, Mark Heckle, Sameh Goubran, Rhadika Mehta, Rohan Goswami, Rami N Khouzam
A paradoxical embolism is defined as a systemic arterial embolus due to passage of a venous thrombus through a right to left shunt. We describe a case of acute cerebral vascular accident (CVA), right subclavian arterial embolus, and pulmonary emboli in the setting of a large patent foramen ovale (PFO). A 74-year-old woman with multiple comorbidities presented to the emergency department with acute onset of shortness of breath, weakness, and right arm pain. She was found to have bilateral pulmonary emboli, left CVA, and a right subclavian arterial embolus on computed tomography (CT)...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29400653/short-term-dual-antiplatelet-therapy-after-interventional-left-atrial-appendage-closure-with-different-devices
#6
Felix K Weise, Stefano Bordignon, Laura Perrotta, Athanasios Konstantinou, Fabrizio Bologna, Takahiko Nagase, Shaojie Chen, K R Julian Chun, Boris Schmidt
AIMS: We aimed to assess the feasibility, efficacy and safety of short-term dual antiplatelet therapy (DAPT) for 6 weeks after left atrial appendage closure (LAAC). METHODS AND RESULTS: Data of the Cardioangiologisches Centrum Bethanien-LAAC registry were analysed. DAPT (aspirin 100mg plus clopidogrel 75mg) was administered until transoesophageal echocardiography (TEE) evaluation 6 weeks after LAAC. In the absence of significant peri-device flow or device-related thrombus (DRT) the medication was decreased to single antiplatelet therapy (SAPT)...
February 6, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29390594/hybrid-repair-of-pectus-excavatum-and-congenital-heart-disease-a-case-report
#7
Xicheng Deng, Peng Huang, Liwen Yi, Xiaohui Yang, Cheng He
RATIONALE: Pectus excavatum (PE) in the setting of congenital heart disease is not uncommon. The surgical strategy has evolved over the last 20 years from a staged approach to simultaneous repair of both defects. PATIENT CONCERNS: A 3-year-old boy was admitted for elective repair of PE and atrial septal defect (ASD). DIAGNOSES: Clinically, there were obvious features of PE and a grade 2 systolic murmur heard loudest at the 2nd intercostal space abutting the left sternal border...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29390347/transcatheter-closure-of-a-huge-iatrogenic-atrial-septal-defect-a-case-report
#8
Yong Yang, Xi Li, Mao Chen, Yuan Feng
RATIONALE: Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma. PATIENT CONCERNS: Herein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement. DIAGNOSES: Transesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29374291/intracardiac-echocardiography-for-percutaneous-patent-foramen-ovale-and-atrial-septal-defect-occlusion
#9
C Kavvouras, M Vavuranakis, S Vaina, K Lampropoulos, G Bazoukis, G Tse, D Tousoulis
BACKGROUND: Transesophageal echocardiography (TEE) plays a unique role in transcatheter closure of atrial septal defects (ASD) and patent foramen ovale (PFO). However, problems such as the need for general anesthesia, possible trauma from endotracheal intubation, presence of "blind spots," and occasional inadequate imaging of some cardiac structures have necessitated better imaging techniques. Our study aimed to compare the findings of TEE during the initial diagnostic examination with those from intracardiac echocardiography (ICE) acquired during the interventional procedure...
January 26, 2018: Herz
https://www.readbyqxmd.com/read/29370349/left-atrial-appendage-resection-can-be-performed-minimally-invasively-with-good-clinical-and-echocardiographic-outcomes-without-any-severe-risk
#10
Takafumi Inoue, Yoshihiro Suematsu
OBJECTIVES: The adverse effects of left atrial appendage (LAA) closure have not yet been evaluated. This study aimed to prove the safety and low invasiveness of LAA resection through our thoracoscopic stand-alone left atrial appendectomy experience. METHODS: Eighty-seven patients [mean age 68 ± 9 years, 68 men (78%), mean congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, prior stroke or transient ischaemic attack to thromboembolism, vascular disease, age 65-74 years and sex category (CHA2DS2-VASc) score 2...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#11
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29336404/role-of-transesophageal-echocardiography-during-left-atrial-appendage-occlusion-device-closure-in-a-patient-with-non-valvular-atrial-fibrillation-and-angiodysplasia-of-the-colon
#12
Dinesh Kumar, Sunil Kumar, Nagraj Desai
Atrial fibrillation is the most common arrhythmia associated with significant mortality and morbidity secondary to thrombo-embolism. To prevent this thrombo-embolism oral anticoagulation therapy is the recommended treatment. In patients with contraindications to oral anticoagulation therapy, percutaneous left atrial appendage occlusion device is indicated. TEE is essential to guide in all the stages of LAA device deployment. Right from pre-procedure screening, to guiding during deployment, to rule out any complications and post-procedure surveillance and monitoring long term outcomes...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29325636/left-atrial-appendage-closure-and-systemic-homeostasis-the-laa-homeostasis-study
#13
Dhanunjaya Lakkireddy, Mohit Turagam, Muhammad Rizwan Afzal, Johnson Rajasingh, Donita Atkins, Buddhadeb Dawn, Luigi Di Biase, Krzysztof Bartus, Saibal Kar, Andrea Natale, David J Holmes
BACKGROUND: The impact of left atrial appendage (LAA) exclusion, comparing an epicardial LAA or an endocardial LAA device, on systemic homeostasis remains unknown. OBJECTIVES: This study compared the effects of epicardial or endocardial LAA devices on the neurohormonal profiles of patients, emphasizing the roles of the renin-angiotensin-aldosterone system and the autonomic nervous system. METHODS: This is a prospective, single-center, observational study including 77 patients who underwent LAA closure by an epicardial (n = 38) or endocardial (n = 39) device...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29304951/left-atrial-appendage-angiography-is-associated-with-the-incidence-and-number-of-magnetic-resonance-imaging-detected-brain-lesions-after-percutaneous-catheter-based-left-atrial-appendage-closure
#14
Andreas Rillig, Barbara Bellmann, Carsten Skurk, David Manuel Leistner, Karl Georg Haeusler, Tina Lin, Rohat Geran, Luzie Koehler, Selma Guttmann, Daniel Steffens, Mario Kasner, Philipp Jakob, Verena Tscholl, Mattias Roser, Klaus Lenz, Kersten Villringer, Jai-Wun Park, Jochen B Fiebach, Ulf Landmesser
BACKGROUND: Percutaneous catheter-based left atrial appendage closure (LAAC) is a procedure being increasingly performed in patients with atrial fibrillation and high bleeding risk. OBJECTIVE: The purpose of this study was to evaluate the incidence of magnetic resonance imaging (MRI)-detected acute brain lesions (ABLs) as well as potential changes in neurocognitive function after percutaneous LAAC in patients with atrial fibrillation. METHODS: Brain MRI at 3 T was performed within 24 hours before and after LAAC along with neurologic (National Institutes of Health Stroke Scale [NIHSS] score) and cognitive (Montreal Cognitive Assessment [MoCA] test) assessment...
January 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#15
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29250272/percutaneous-left-atrial-appendage-closure-is-there-a-role-in-valvular-atrial-fibrillation
#16
REVIEW
Chetan Huded, Amar Krishnaswamy, Samir Kapadia
Atrial fibrillation, a chronic and highly morbid cardiovascular condition which affects over 33 million people worldwide, can be broadly categorized as valvular vs non-valvular in etiology. However, definitions of valvular atrial fibrillation have varied widely in the literature, and there is no clear consensus definition to date. Historically, patients with atrial fibrillation in the setting of rheumatic mitral valve disease have constituted a particularly high risk group for cardioembolic stroke, and for this reason many contemporary trials of pharmaceutical and device therapies for atrial fibrillation have systematically excluded patients with valvular heart disease...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250246/leaks-after-left-atrial-appendage-ligation-with-lariat-device-incidence-pathophysiology-clinical-implications-and-methods-of-closure-a-case-based-discussion
#17
Bharath Yarlagadda, Valay Parikh, Tawseef Dar, Dhanunjaya Lakkireddy
Catheter based left atrial appendage (LAA) closure techniques are emerging as a promising alternative for stroke prevention in patients who cannot tolerate oral anticoagulation. Lariat procedure involves percutaneous catheter based epicardial ligation of the LAA with a suture via an endo-epicardial hybrid approach. It offers the advantage of not leaving behind a focus for thrombus formation or embolization. Similar to surgical ligation of the left atrial appendage, Lariat ligation is limited by leaks in a small percentage of patients...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29233088/left-atrial-enlargement-and-clinical-considerations-in-patients-with-or-without-a-residual-interatrial-shunt-after-closure-of-the-left-atrial-appendage-with-the-watchman%C3%A2-device
#18
Blerim Luani, Thomas Groscheck, Conrad Genz, Ivan Tanev, Thomas Rauwolf, Joerg Herold, Senad Medunjanin, Alexander Schmeisser, Rüdiger C Braun-Dullaeus
BACKGROUND: Interventional closure of the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation, high thromboembolic and bleeding risk or bleeding history is an alternative therapeutic strategy to oral anticoagulation. It is not known if the exclusion of the LAA from the blood circulation affects the left atrial volume (LAV) and consequently its prognostic value or the circulatory performance of the heart in humans. METHODS: We aimed to prospectively assess potential changes in baseline LAV, left ventricular ejection fraction (LVEF), NT-proBNP-level and the covered distance in the 6-min walk-test 6 weeks and 6 months after LAA closure with the WATCHMAN™ device...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29222738/ct-based-3d-printing-is-superior-to-transesophageal-echocardiography-for-pre-procedure-planning-in-left-atrial-appendage-device-closure
#19
Edinrin Obasare, Sumeet K Mainigi, D Lynn Morris, Leandro Slipczuk, Igor Goykhman, Evan Friend, Mary Rodriguez Ziccardi, Gregg S Pressman
Accurate assessment of the left atrial appendage (LAA) is important for pre-procedure planning when utilizing device closure for stroke reduction. Sizing is traditionally done with transesophageal echocardiography (TEE) but this is not always precise. Three-dimensional (3D) printing of the LAA may be more accurate. 24 patients underwent Watchman device (WD) implantation (71 ± 11 years, 42% female). All had complete 2-dimensional TEE. Fourteen also had cardiac computed tomography (CCT) with 3D printing to produce a latex model of the LAA for pre-procedure planning...
December 8, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29194654/safety-and-efficacy-analysis-of-one-stop-intervention-for-treating-nonvalvular-atrial-fibrillation
#20
Hongde Hu, Kaijun Cui, Jian Jiang, Hua Fu, Rui Zeng
BACKGROUND: Nonvalvular atrial fibrillation (AF) is a common arrhythmia. The treatment strategy for AF mainly includes controlling symptoms and decreasing the rate of complications. Our study aimed to evaluate the safety and efficacy of combination treatment of catheter ablation and left atrial appendage (LAA) closure (one-stop intervention) in patients with nonvalvular AF. METHODS AND RESULTS: Thirty-four patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
November 30, 2017: Pacing and Clinical Electrophysiology: PACE
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