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Left Atrial Appendage

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https://www.readbyqxmd.com/read/28314700/structural-heart-disease-intervention-the-canadian-landscape
#1
Anita W Asgar, Eric Horlick, Kevin McKenzie, Neil Brass, Warren J Cantor, Albert Chan, Anthony Della Siega, Jean Francois Gobeil, Saleem Kassam, Michael P Love, Samer Mansour, Giuseppe Martucci, Najaf Nadeem, Madhu K Natarajan, Vernon Paddock, Josep Rodés-Cabau, Mouhieddin Traboulsi, James L Velianou, Robert C Welsh, David Wood, John G Webb
Cardiovascular disease encompasses coronary artery disease and valvular heart disease, and the prevalence of both increases with age. Over the past decade, the landscape of interventional cardiology has evolved to encompass a new set of percutaneous procedures outside the coronary tree, including transcatheter aortic valve implantation, transcatheter mitral valve repair, and left atrial appendage occlusion. These interventions have sparked a new discipline within interventional cardiology referred to as structural heart disease (SHD) intervention...
December 13, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28303634/novel-integrated-3d-multidetector-computed-tomography-and-fluoroscopy-fusion-for-left-atrial-appendage-occlusion-procedures
#2
A K Roy, J Horvilleur, B Cormier, M Cazalas, L Fernandez, M Patane, A Neylon, M Spaziano, F J Sawaya, T Arai, E Bouvier, T Hovasse, T Lefèvre, B Chevalier, P Garot
OBJECTIVES: This report demonstrates the application and feasibility of novel 3D-MDCT real-time fusion technology with fluoroscopy, for left atrial appendage (LAA) occlusion procedures. BACKGROUND: A successful LAA occlusion procedure relies on multiple imaging modalities, including TEE or 3D-MDCT, and fluoroscopy. Effectively integrating these imaging modalities may improve implantation safety and success. To our knowledge this technique has not been previously described for LAA occlusions...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#3
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28295609/serum-galectin-3-level-as-a-marker-of-thrombogenicity-in-atrial-fibrillation
#4
Duygu Kocyigit, Kadri Murat Gurses, Muhammed Ulvi Yalcin, Hande Canpinar, Ugur Canpolat, Banu Evranos, Hikmet Yorgun, Necla Ozer, Dicle Guc, Kudret Aytemir
BACKGROUND: Left atrial appendage flow velocity (LAAFV) and presence of spontaneous echo contrast (SEC) have been reported to be predictors of thromboembolism in atrial fibrillation (AF) patients. Galectin-3 is a biomarker reflecting pro-inflammatory status, whose role in AF has recently drawn attention, particularly in persistent AF population. AIM: In this study we aimed to investigate the association between serum galectin-3 levels and echocardiographic predictors of thromboembolism in persistent AF patients...
March 13, 2017: Journal of Clinical Laboratory Analysis
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
#5
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/28290880/-treatment-of-patients-with-atrial-fibrillation-the-search-for-optimal-solutions
#6
S G Kanorskii
Atrial fibrillation (AF) - the most common arrhythmia in clinical practice, impair the quality of life significantly increases morbidity and mortality. Current methods of treatment of patients with AF, except anticoagulant therapy hitherto failed to provide significant improvement in cardiovascular events are of limited effectiveness and cause significant side effects. The article presents the current opportunities and challenges for the treatment of patients with atrial fibrillation. Analysis of these data will allow for an informed choice of treatment facilities for individual patients...
August 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289527/left-atrial-appendage-occlusion-a-better-alternative-to-anticoagulation
#7
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/28289072/downregulation-of-mir-15a-b-accelerates-fibrotic-remodelling-in-the-type-2-diabetic-human-and-mouse-heart
#8
Shruti Rawal, Pujika Emani Munasinghe, Prashanth Thevakar, Jason Kar Sheng Lew, Gregory T Jones, Michael Ja Willams, Philip Davis, Richard W Bunton, Ivor F Galvin, Patrick Manning, Regis R Lamberts, Rajesh G Katare
AIM: Myocardial fibrosis is a well established cause of increased myocardial stiffness and subsequent diastolic dysfunction in the diabetic heart. The molecular regulators that drive the process of fibrotic events in the diabetic heart are still unknown. We determined the role of the microRNA (miR)-15 family in fibrotic remodelling of the diabetic heart. METHODS AND RESULTS: Right atrial appendage (RAA) and left ventricular (LV) biopsy tissues collected from diabetic and non-diabetic patients undergoing coronary artery bypass graft surgery showed significant downregulation of miR-15a and -15b...
March 13, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28288200/morphological-features-of-the-left-atrial-appendage-in-consecutive-coronary-computed-tomography-angiography-patients-with-and-without-atrial-fibrillation
#9
Miika Korhonen, Johannes Parkkonen, Marja Hedman, Antti Muuronen, Juha Onatsu, Pirjo Mustonen, Ritva Vanninen, Mikko Taina
The majority of intracardiac thrombi form in the left atrial appendage (LAA). Enlargement of this structure, together with certain morphological features, may indicate a predisposition to the formation of thrombi and subsequent cardioembolic stroke. Thus far, studies on LAA morphology have largely focused on those patients with atrial fibrillation (AF). Taking a different approach, we investigated the variation in LAA morphology in a consecutive patient population with and without AF. We evaluated 808 consecutive patients (529 females; mean age 52...
2017: PloS One
https://www.readbyqxmd.com/read/28287031/comparison-of-diverse-platelet-activation-markers-as-indicators-for-left-atrial-thrombus-in-atrial-fibrillation
#10
Daniel Tarnowski, David M Poitz, Lina Plichta, Felix M Heidrich, Stephan Wiedemann, Tobias Ruf, Johannes Mierke, Tobias Löhn, Stefanie Jellinghaus, Ruth H Strasser, Karim Ibrahim, Christian Pfluecke
Atrial fibrillation (AF) is well known for being a major risk factor of thromboembolic stroke. We could recently demonstrate an association of monocyte-platelet aggregates (MPAs) with the degree of thrombogenicity in patients with AF. This study investigated platelet activation markers, as potential biomarkers for the presence of left atrial (LA) thrombus in patients with AF. One hundred and eight patients with symptomatic AF underwent transesophageal echocardiography (TEE) before scheduled cardioversion or pulmonary vein isolation...
March 13, 2017: Platelets
https://www.readbyqxmd.com/read/28281734/percutaneous-left-atrial-appendage-occlusion-new-perspectives-for-the-method
#11
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/28274702/computed-tomography-x-ray-fusion-in-left-atrial-appendage-closure
#12
Manuel Barreiro-Pérez, Ignacio Cruz-González, Pedro L Sánchez
No abstract text is available yet for this article.
March 5, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28271292/prevalence-of-right-atrial-non-pulmonary-vein-triggers-in-atrial-fibrillation-patients-treated-with-thyroid-hormone-replacement-therapy
#13
Ki-Hun Kim, Sanghamitra Mohanty, Prasant Mohanty, Chintan Trivedi, Eli Hamilton Morris, Pasquale Santangeli, Rong Bai, Amin Al-Ahmad, John David Burkhardt, Joseph G Gallinghouse, Rodney Horton, Javier E Sanchez, Shane Bailey, Patrick M Hranitzky, Jason Zagrodzky, Soo G Kim, Luigi Di Biase, Andrea Natale
BACKGROUND: Thyroid hormone (TH) is known to enhance arrhythmogenicity, and high-normal thyroid function is related with an increased recurrence of atrial fibrillation (AF) after catheter ablation. However, the impact of thyroid hormone replacement (THR) on AF ablation is not well known. METHODS: This study evaluated 1163 consecutive paroxysmal AF patients [160 (14%) on THR and 1003 (86%) without THR] undergoing their first catheter ablation. A total of 146 patients on THR and 146 controls were generated by propensity matching, based on calculated risk factor scores, using a logistic model (age, sex, body mass index, and left atrium size)...
March 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28262290/left-atrial-appendage-exclusion-an-alternative-to-anticoagulation-in-nonvalvular-atrial-fibrillation
#14
EDITORIAL
Kareem Bedeir, David R Holmes, James L Cox, Basel Ramlawi
No abstract text is available yet for this article.
February 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28259694/techniques-for-provocation-localization-and-ablation-of-nonpulmonary-vein-triggers-for-atrial-fibrillation
#15
Pasquale Santangeli, Francis E Marchlinski
The endpoint of current catheter-based ablation approaches for the treatment of atrial fibrillation (AF) is the elimination of all the possible triggers with the least amount of ablation necessary. Once all the triggers have been eliminated, the incremental value of any additional lesion sets remains to be proven. Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation approaches for eliminating AF triggers. However, up to 11% of patients demonstrate reproducible sustained AF initiation from non-PV foci...
March 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28256020/left-atrial-anatomy-and-patient-related-factors-associated-with-adverse-outcomes-with-the-watchman-device-a-real-world-experience
#16
Shishir Murarka, Mohamad Lazkani, Soundos Moualla, Divya Ratan Verma, Ashish Pershad
OBJECTIVE: This study sought to identify patient and left atrial morphology specific factors associated with early complications for left atrial appendage occlusion with the Watchman™ (Boston Scientific, Natick, MA) device. BACKGROUND: Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation, however, long-term OAC compliance is poor. In randomized control trials, the Watchman™ device has demonstrated superiority over OAC with warfarin for all cause and cardiovascular mortality and hemorrhagic stroke...
March 2, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28255107/a-new-strategy-for-transcatheter-left-atrial-appendage-closure-with-cerebral-embolic-protection-in-patient-with-left-auricular-thrombosis-and-total-contraindication-to-long-term-anticoagulation
#17
Salvatore Saccà, Jayme Ferro, Tomoyuki Umemoto, Riccardo Turri, Carlo Penzo, Andrea Pacchioni
Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring in 1%-2% of the general population. An important aspect is the treatment of AF in terms of stroke prevention. In patients with absolute contraindication to long-term anticoagulation due to high bleeding risk, a valuable alternative exists in left atrial appendage (LAA) closure. Unfortunately, thrombus in the LAA is a contraindication to the procedure because of high risk of embolization. We describe a clinical case with permanent AF, absolute contraindication to long-term anticoagulation therapy, and persistent thrombus formation in the LAA that was treated with transcatheter LAA closure and supraaortic trunk protection system in order to avoid risk of periprocedural stroke...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28245948/percutaneous-closure-of-iatrogenic-femoral-arteriovenous-fistula-using-a-covered-coronary-stent
#18
Juan Carlos Rama-Merchan, Ignacio Cruz-González, Javier Martín-Moreiras, Alejandro Diego-Nieto, Javier Rodríguez-Collado, Pedro Luis Sánchez
We present the case of a patient with a high-output fistula between the right superficial femoral artery and femoral vein after left atrial appendage closure successfully treated with a PK-Papyrus covered coronary stent using a 6F guiding catheter. To the best of our knowledge this is the first time a PK-Papyrus coronary stent has been used in this setting.
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28245798/left-atrial-appendage-morphology-and-risk-of-stroke-following-pulmonary-vein-isolation-for-drug-refractory-atrial-fibrillation-in-low-cha2ds2vasc-risk-patients
#19
Faith R Kelly, Robert A Hull, Takor B Arrey-Mbi, Michael U Williams, Joshua S Lee, Ahmad M Slim, Dustin M Thomas
BACKGROUND: Cardiac CT angiography (CCTA) has become an important adjunct in the structural assessment of the pulmonary veins (PV) prior to pulmonary vein isolation (PVI). Published data is conflicting regarding a relationship between left atrial appendage (LAA) and the risk of ischemic stroke (CVA) following PVI. We investigated the associations of volumetric and morphologic left atrial (LA) and LAA measurements for CVA following PVI. METHODS: We retrospectively reviewed 332 consecutive patients with drug refractory atrial fibrillation who obtained cardiac CT angiogram (CCTA) prior to PVI...
February 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28243428/non-pharmacologic-approach-to-prevent-embolization-in-patients-with-atrial-fibrillation-in-whom-anticoagulation-is-contraindicated
#20
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
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