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laa occluder

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https://www.readbyqxmd.com/read/27815629/pulmonary-artery-perforation-and-coronary-air-embolism-two-fatal-outcomes-in-percutaneous-left-atrial-appendage-occlusion
#1
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/27591691/closure-of-left-atrial-appendage-with-persistent-distal-thrombus-using-an-amplatzer-amulet-occluder
#2
Mathias Lange, Helmut Bültel, Heinrich Weglage, Patrick Löffeld, Thomas Wichter
A 73-year-old patient with permanent atrial fibrillation presented for left atrial appendage (LAA) occlusion. Transesophageal echocardiography demonstrated a thrombus in the distal LAA. This image series illustrates a "no touch" technique that was used to ensure successful implantation of an Amplatzer Amulet LAA occlusion device without the use of an embolization protection system.
September 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27476858/learning-curve-assessment-for-percutaneous-left-atrial-appendage-closure-with-the-watchman-occluder
#3
Jakob Ledwoch, Christine Krollmann, Stephan Staubach, Martin Hug, Henning Strohm, Harald Mudra
OBJECTIVES: We sought to evaluate the effect of increasing experience with left atrial appendage (LAA) closure on short-term outcome. BACKGROUND: Data regarding the impact of the learning curve of LAA closure-particularly regarding technical aspects of the procedure-are lacking. METHODS: The present analysis represents first data from a single-center all-comer registry. The population was divided into 3 groups according to treatment time (group 1: patients 1-30; group 2: patients 31-60; group 3: patients 61-90)...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27402623/concomitant-cryoballoon-ablation-and-percutaneous-closure-of-left-atrial-appendage-in-patients-with-atrial-fibrillation
#4
Gaetano Fassini, Sergio Conti, Massimo Moltrasio, Anna Maltagliati, Fabrizio Tundo, Stefania Riva, Antonio Dello Russo, Michela Casella, Benedetta Majocchi, Martina Zucchetti, Eleonora Russo, Vittoria Marino, Mauro Pepi, Claudio Tondo
AIMS: Pulmonary veins (PVs) isolation is the cornerstone of atrial fibrillation (AF) ablation and can be achieved either by conventional radiofrequency ablation or by cryoenergy. Left atrial appendage (LAA) closure has been proposed as alternative treatment to vitamin K antagonists (VKA). We aimed to evaluate the feasibility of combining cryoballoon (CB) ablation and LAA occlusion in patients with AF and a high thromboembolic risk or contraindication to antithrombotic therapy. METHODS AND RESULTS: Thirty-five patients (28 males, 74 ± 2 years) underwent CB ablation...
July 11, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27388826/predictors-of-early-1-week-outcomes-following-left-atrial-appendage-closure-with-amplatzer-devices
#5
Konstantinos C Koskinas, Samera Shakir, Máté Fankhauser, Fabian Nietlispach, Adrian Attinger-Toller, Aris Moschovitis, Peter Wenaweser, Thomas Pilgrim, Stefan Stortecky, Fabien Praz, Lorenz Räber, Stephan Windecker, Bernhard Meier, Steffen Gloekler
OBJECTIVES: The aim of this study was to assess predictors of adverse 1-week outcomes and determine the effect of left atrial appendage (LAA) morphology following LAA closure (LAAC) with Amplatzer devices. BACKGROUND: Percutaneous LAAC is a valuable treatment option for stroke prevention in patients with atrial fibrillation. Determinants of procedural safety events with Amplatzer occluders are not well established, and the possibly interrelating effect of LAA anatomy is unknown...
July 11, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27219618/the-new-3d-printed-left-atrial-appendage-closure-with-a-novel-holdfast-device-a-pre-clinical-feasibility-animal-study
#6
M Brzeziński, K Bury, L Dąbrowski, P Holak, A Sejda, M Pawlak, D Jagielak, Z Adamiak, J Rogowski
INTRODUCTION: Many patients undergoing cardiac surgery have risk factors for both atrial fibrillation (AF) and stroke. The left atrial appendage (LAA) is the primary site for thrombi formation. The most severe complication of emboli derived from LAA is stroke, which is associated with a 12-month mortality rate of 38% and a 12-month recurrence rate of 17%. The most common form of treatment for atrial fibrillation and stroke prevention is the pharmacological therapy with anticoagulants...
2016: PloS One
https://www.readbyqxmd.com/read/27212972/early-operative-comparison-of-two-epicardial-left-atrial-appendage-occluding-systems-applied-during-off-pump-coronary-revascularisation-in-patients-with-persistent-atrial-fibrillation
#7
Grzegorz Suwalski, Robert Emery, Leszek Gryszko, Kamil Kaczejko, Arkadiusz Żegadło, Emilia Frankowska, Jakub Mróz, Andrzej Skrobowski
INTRODUCTION: Atrial fibrillation (AF) increases long-term mortality and stroke rate in patients having coronary artery bypass grafting (CABG). Because oral anticoagulation (OAC) is associated with both a significant incidence of discontinuation and well known complication rates, left atrial appendage occlusion might be beneficial for stroke prevention. This study presents the first clinical and practical comparison of two epicardial left appendage occluders (LAAO) accruing experience in application during off-pump coronary revascularisation in patients with persistent AF...
March 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27160643/intraoperative-assessment-of-left-atrial-diverticulum-and-remnant-stump-after-left-atrial-appendage-epicardial-occlusion
#8
Grzegorz Suwalski, Robert Emery, Leszek Gryszko, Kamil Kaczejko, Jakub Mroz, Andrzej Skrobowski
OBJECTIVES: Epicardial left atrial appendage (LAA) closure with use of occluder is an emerging technique. Absence of remnant LAA stump is major criterion of successful obliteration. The aim of study was to assess early success rate of epicardial LAA closure. METHODS: Fifteen patients with persistent AF and coronary artery disease underwent off-pump coronary revascularization with concomitant ablation and LAA epicardial occlusion with use of two types of occluders...
September 2016: Echocardiography
https://www.readbyqxmd.com/read/27143657/asymptomatic-migration-of-an-amplatzer%C3%A2-amulet%C3%A2-left-atrial-appendage-occluder-through-the-mitral-valve
#9
Petru Mester, Antoine Dompnier, Loïc Belle
An 84-year-old woman with a history of hemorrhagic stroke was admitted for a new cerebral ischemic event. While in hospital, she was diagnosed with paroxysmal atrial fibrillation. Owing to her high thromboembolic risk (CHA2 DS2 -VASc score of 6) we performed left atrial appendage (LAA) closure using a 22-mm AMPLATZER™ Amulet™. The procedure was successful. Systematic follow-up with transthoracic echocardiography 8 hr later revealed that the LAA occluder had migrated and become entrapped in the mitral subvalvular apparatus...
May 3, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27122600/the-left-atrial-appendage-from-embryology-to-prevention-of-thromboembolism
#10
Giuseppe Patti, Vittorio Pengo, Rossella Marcucci, Plinio Cirillo, Giulia Renda, Francesca Santilli, Paolo Calabrò, Alberto Ranieri De Caterina, Ilaria Cavallari, Elisabetta Ricottini, Vito Maurizio Parato, Giacomo Zoppellaro, Giuseppe Di Gioia, Pietro Sedati, Vincenzo Cicchitti, Giovanni Davì, Enrica Golia, Ivana Pariggiano, Paola Simeone, Rosanna Abbate, Domenico Prisco, Marco Zimarino, Francesco Sofi, Felicita Andreotti, Raffaele De Caterina
The left atrial appendage (LAA) is the main source of thromboembolism in patients with non-valvular atrial fibrillation (AF). As such, the LAA can be the target of specific occluding device therapies. Optimal management of patients with AF includes a comprehensive knowledge of the many aspects related to LAA structure and thrombosis. Here we provide baseline notions on the anatomy and function of the LAA, and then focus on current imaging tools for the identification of anatomical varieties. We also describe pathogenetic mechanisms of LAA thrombosis in AF patients, and examine the available evidence on treatment strategies for LAA thrombosis, including the use of non-vitamin K antagonist oral anticoagulants and interventional approaches...
April 26, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27009279/-laa-occluder-view-for-post-implantation-evaluation-love-standardized-imaging-proposal-evaluating-implanted-left-atrial-appendage-occlusion-devices-by-cardiac-computed-tomography
#11
Michael Behnes, Ibrahim Akin, Benjamin Sartorius, Christian Fastner, Ibrahim El-Battrawy, Martin Borggrefe, Holger Haubenreisser, Mathias Meyer, Stefan O Schoenberg, Thomas Henzler
BACKGROUND: A standardized imaging proposal evaluating implanted left atrial appendage (LAA) occlusion devices by cardiac computed tomography angiography (cCTA) has never been investigated. METHODS: cCTA datasets were acquired on a 3(rd) generation dual-source CT system and reconstructed with a slice thickness of 0.5 mm. An interdisciplinary evaluation was performed by two interventional cardiologists and one radiologist on a 3D multi-planar workstation. A standardized multi-planar reconstruction algorithm was developed in order to assess relevant clinical aspects of implanted LAA occlusion devices being outlined within a pictorial essay...
March 24, 2016: BMC Medical Imaging
https://www.readbyqxmd.com/read/26916569/veno-venous-double-lasso-pull-and-push-technique-for-transseptal-retrieval-of-an-embolized-watchman-occluder
#12
Christian Fastner, Ralf Lehmann, Michael Behnes, Benjamin Sartorius, Martin Borggrefe, Ibrahim Akin
Intraprocedural device dislodgement of a 24-mm Watchman™ left atrial appendage (LAA) closure device occurred in a 83-year-old female with a wide left atrial appendage ostium (broccoli configuration) and a surgical mitral valve reconstruction. Device rested in the atrial cavity. A second stable 12French transseptal electrophysiological sheath and two snares were needed to stabilize, elongate and gently guide the device into the second sheath. One of the snares was unclamped at its proximal end and retrogradely pulled through...
April 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/26638585/clinical-results-of-left-atrial-appendage-closure-with-watchman-device-in-patients-with-atrial-fibrillation
#13
Phattaraphong Pheerawong, Smonporn Boonyaratavej Songmuang, Vorarit Lertsuwunseri, Sudarat Satitthummanid, Suphot Srimahachota
BACKGROUND: In patient with non-valvular atrial fibrillation (AF), over 90% of thrombus accumulation originates in the left atrial appendage (LAA). Warfarin significantly reduces risk of stroke. However, long-term anticoagulant therapy is associated with a significant risk of major bleeding, particularly in elderly. Transcatheter occlusion of left atrial appendage with Watchman device has proved to be non-inferior to warfarin in preventing stroke in non-valvular AF patients. No previous report of transcatheter occlusion of LAA was found in Thailand OBJECTIVE: To evaluate short-term results of left atrial appendage closure with the Watchman® device in patient with non-valvular AF performed at King Chulalongkorn Memorial Hospital (KCMH)...
October 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/26523825/new-approach-to-exclude-the-left-atrial-appendage-during-minimally-invasive-cryothermic-surgical-ablation
#14
Niv Ad, Paul S Massimiano, Deborah J Shuman, Graciela Pritchard, Sari D Holmes
OBJECTIVE: Atrial fibrillation (AF) is associated with an increased risk for embolic stroke originating from the left atrial appendage (LAA). A recently introduced LAA epicardial clip occluder, the AtriClip PRO, can be applied through midsternotomy or small thoracotomy. We assessed the safety and efficacy of a new surgical approach to apply the AtriClip PRO and exclude the LAA through right minithoracotomy and transverse sinus. METHODS: The AtriClip PRO was applied in 24 patients with the new approach...
September 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/26495822/an-update-on-atrial-fibrillation-focus-on-stroke-risk-reduction-strategies
#15
T S Potpara, V Jokic, B Medic, M Prostran, G Y Lip
Atrial fibrillation (AF) currently affects approximately 2% of the general adult population, and the number of patients suffering from AF constantly increases. Although the occurrence of AF rarely poses an immediate threat to patient's survival, the arrhythmia is associated with significant cardiovascular morbidity and mortality mostly resulting from ischemic stroke or systemic thromboembolism, or heart failure. Overall, patients with AF have a 5-fold greater risk of stroke compared to individuals in sinus rhythm, but individual stroke risk depends on the presence of various stroke risk factors, and optimal stroke prevention is essential for AF patients...
October 23, 2015: Minerva Medica
https://www.readbyqxmd.com/read/26354821/left-atrial-appendage-closure-first-in-man-with-the-4th-generation-watchman-device
#16
Jakob Ledwoch, Jennifer Franke, Maik Gonzaga, Stefan Bertog, Annkathrin Braut, Ilona Hofmann, Laura Vaskelyte, Sameer Gafoor, Vivek Reddy, Horst Sievert
OBJECTIVES: To evaluate the feasibility and safety of the fourth generation WATCHMAN device. BACKGROUND: The WATCHMAN left atrial appendage (LAA) closure device has been shown to be non-inferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with non-valvular atrial fibrillation. A new (fourth) generation of the WATCHMAN device was designed to facilitate easier delivery and improve safety. METHODS: We conducted a prospective, non-randomized study of LAA closure with use of the 4(th) generation WATCHMAN device in 36 patients with non-valvular atrial fibrillation...
March 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26199065/catch-of-the-day-interventional-device-retrieval-after-late-embolization-of-an-amplatzer-cardiac-plug-left-atrial-appendage-occluder
#17
LETTER
Vedat Tiyerili, Georg Nickenig, Christoph Hammerstingl
Transcatheter left atrial appendage (LAA) closure has proven to be an effective method to reduce the risk of thromboembolic events in patients who have nonvalvular atrial fibrillation (AF) that is unsuitable for chronic oral anticoagulation. In this case report, we describe the rare case of a late LAA occluder (28-mm Amplatzer cardiac plug) embolization, which was treated uneventfully with interventional device capture. Special interventional and device specific characteristics must be taken into account when planning such a complex procedure as described in our case...
December 2015: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/26022824/strategies-to-incorporate-left-atrial-appendage-occlusion-into-clinical-practice
#18
REVIEW
Oluseun Alli, Samuel Asirvatham, David R Holmes
The left atrial appendage (LAA) has been identified as a predominant source of thrombus formation leading to significant thromboembolic events in patients with nonvalvular atrial fibrillation. Medical therapy to eliminate thrombus formation in the LAA has been the standard of care for several decades, but mechanical approaches designed to exclude the LAA from the circulation have recently been developed. The largest body of randomized and nonrandomized data to date has been for the Watchman device (Boston Scientific, Natick, Massachusetts), which was recently approved by the Food and Drug Administration for selected patients in the United States...
June 2, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/25935163/combined-catheter-ablation-and-left-atrial-appendage-closure-as-a-hybrid-procedure-for-the-treatment-of-atrial-fibrillation
#19
Naiara Calvo, Nahikari Salterain, Hugo Arguedas, Alfonso Macias, Alberto Esteban, Manuel García de Yébenes, Juan J Gavira, Joaquín Barba, Ignacio García-Bolao
AIMS: Left atrial appendage (LAA) is the source of thrombi in up to 90% of patients with non-valvular atrial fibrillation (AF). Catheter ablation (CA) is an effective treatment for symptomatic AF and, in selected cases, LAA occlusion devices have been introduced as an alternative to oral anticoagulants (OACs). The safety and feasibility of combining CA and percutaneous LAA closure (LAAC) are unknown. METHODS AND RESULTS: Patients with symptomatic drug-refractory AF, CHADS2 score of ≥1, and CHA2DS2-VASc score ≥2 were included...
October 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/25929303/left-atrial-appendage-closure-with-amplatzer-septal-occluder-in-patients-with-atrial-fibrillation-ct-based-morphologic-considerations
#20
Paul T Vaitkus, Dee Dee Wang, Mayra Guerrero, Adam Greenbaum, William O'Neill
OBJECTIVES: This study analyzed left atrial appendage (LAA) dimensions measured by computed tomography (CT) scan to define optimal selection of Amplatzer septal occluders for LAA closure. BACKGROUND: Patients with atrial fibrillation and contraindications to anticoagulation have limited options for LAA closure until approval of dedicated closure devices. Off-label use of available cardiac devices represents one option. METHODS: All consecutive patients undergoing LAA occlusion with an Amplatzer device who had undergone CT scanning were included...
May 2015: Journal of Invasive Cardiology
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