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https://www.readbyqxmd.com/read/29590386/surgical-management-of-the-left-atrial-appendage-a-must-or-a-myth
#1
Thorsten Hanke
Surgical treatment of the left atrial appendage (LAA) has increased over the past few years. The most serious complication of atrial fibrillation is a cerebral cardioembolic stroke. In most patients with atrial fibrillation, the LAA is the anatomical source of the embolism. Several surgical techniques for occluding the LAA using different devices have been developed with different prospects of success. It is still not clear which of these techniques represents the optimum treatment for reducing the incidence of stroke in patients with atrial fibrillation...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29540492/percutaneous-left-atrial-appendage-closure-is-a-reasonable-option-for-patients-with-atrial-fibrillation-at-high-risk-for-cerebrovascular-events
#2
Emmanuel Teiger, Jean-Benoit Thambo, Pascal Defaye, Jean-Sylvain Hermida, Sélim Abbey, Didier Klug, Jean-Michel Juliard, Jean-Luc Pasquie, Gilles Rioufol, Antoine Lepillier, Meyer Elbaz, Jerome Horvilleur, Philippe Brenot, Bertrand Pierre, Philippe Le Corvoisier
BACKGROUND: Percutaneous left atrial appendage (LAA) closure is an emerging option for patients with atrial fibrillation at high risk for cerebrovascular events. The multicenter FLAAC registry (French Nationwide Observational LAA Closure Registry) was established to assess LAA closure outcomes in everyday practice. METHODS AND RESULTS: Four hundred thirty-six patients referred from April 2013 to September 2015 to 33 French interventional cardiology centers for percutaneous LAA closure were included prospectively in the FLAAC registry...
March 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29512094/two-dimensional-versus-three-dimensional-transesophageal-echocardiography-in-percutaneous-left-atrial-appendage-occlusion
#3
Witold Streb, Katarzyna Mitręga, Tomasz Podolecki, Magdalena Szymała, Anna Leopold-Jadczyk, Tomasz Kukulski, Zbigniew Kalarus
BACKGROUND: Real-time three-dimensional transesophageal echocardiography (RT3D TEE) enables better visualization of the left atrial appendage (LAA) and may be superior to real-time two-dimensional transesophageal echocardiography (RT2D TEE) for LAA occlusion (LAAO). The aim of this study was to assess inter- and intra-observer variability of RT2D TEE and RT3D TEE measurements of LAA, and to assess the accordance of RT2D TEE and RT3D TEE with appropriate occluder selection. METHODS: Transesophageal echocardiography was performed in 40 patients during LAAO...
March 7, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29385439/emergent-surgical-removal-of-a-migrated-left-atrial-appendage-occluder
#4
Mohamed El-Gabry, Sharaf-Eldin Shehada, Daniel Wendt, Fanar Mourad
Occlusion of the left atrial appendage (LAA) in patients with atrial fibrillation has become a standard therapy to prevent thromboembolic complications. We aim to present 3 cases of LAA occluder embolization after percutaneous WATCHMAN™ device implantation, which required emergent surgical retrieval. The device was dislocated in the left atrium, introducing LAA perforation and resulting in pericardial effusion and later tamponade in 1 patient who developed multiorgan failure and died 8 days postoperatively...
January 29, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29374188/impact-of-left-atrial-appendage-morphology-on-thrombus-formation-after-successful-left-atrial-appendage-occlusion-assessment-with-cardiac-computed-tomography
#5
Wulf Dieker, Michael Behnes, Christian Fastner, Benjamin Sartorius, Annika Wenke, Ishar Sing-Gill, Ibrahim El-Battrawy, Jürgen Kuschyk, Theano Papavassiliu, Ursula Hoffmann, Kambis Mashayekhi, Stefan O Schoenberg, Martin Borggrefe, Thomas Henzler, Ibrahim Akin
A standardized imaging algorithm by cardiac computed tomography angiography (cCTA) (LOVE-view) was used in 30 patients to evaluate the influence of different left atrial appendage (LAA) morphologies on development of thrombosis in the LAA 6 months after implantation of an occlusion device (Watchman or Amplatzer-Cardiac-Plug) in patients with non-valvular atrial fibrillation, CHA2 DS2 -VASc-Score >1 and a contraindication for oral anticoagulation. The distribution of different LAA morphologies was 40% windsock, 17% broccoli and 43% chicken wing type...
January 26, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29360987/residual-echocardiographic-and-computed-tomography-findings-after-thoracoscopic-occlusion-of-the-left-atrial-appendage-using-the-atriclip-pro-device
#6
Pavel Osmancik, Petr Budera, Jana Zdarska, Dalibor Herman, Robert Petr, Richard Fojt, Zbynek Straka
OBJECTIVES: Thoracoscopic occlusion of the left atrial appendage (LAA) has become a routine part of thoracoscopic ablation for the treatment of atrial fibrillation (AF). Evaluation of residual findings of the occluded LAA by echocardiography has yet to be described. METHODS: Patients with AF indicated for hybrid ablation (thoracoscopic procedure followed by catheter ablation) were enrolled in this study. LAA was occluded as a routine part of the thoracoscopic procedure...
January 18, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29297907/-combined-left-atrial-appendage-percutaneous-closure-and-atrial-fibrillation-ablation-a-single-center-experience
#7
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/29289951/cardioembolic-stroke-in-patient-with-transcatheter-occluded-left-atrial-appendage
#8
Umberto Cucchini, Denisa Muraru, Luigi P Badano
A cerebral ischemic event in a patient managed with left atrial appendage (LAA) transcatheter obliteration is illustrated. Transesophageal echocardiography allowed identification and accurate definition of the LAA device leakage.
January 2018: Journal of Invasive Cardiology
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
#9
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/29181735/-oral-anticoagulation-and-platelet-inhibition-after-atrial-appendage-occlusion
#10
REVIEW
Martin W Bergmann, Carsten W Israel
In Europe left atrial appendage occluders (LAAO) are most frequently used in patients with contraindications for oral anticoagulation (OAC); therefore, the classical therapeutic OAC scheme from the PROTECT-AF trial (vitamin K antagonist plus acetylsalicylic acid) is usually changed to dual anti-platelet therapy (DAPT) after implantation of a Watchman® or Amulet® LAAO (St. Jude Medical/Abbott, Eschborn, Germany). For many years, patients with an LAAO received DAPT for 1-6 months. The current standard comprises DAPT for 3 months, followed by permanent acetylsalicylic acid monotherapy if the transesophageal echocardiogram excludes a thrombus at the site of the LAAO...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29149516/feasibility-of-percutaneous-left-atrial-appendage-closure-using-a-novel-lambre-occluder-in-patients-with-atrial-fibrillation-initial-results-from-a-prospective-cohort-registry-study
#11
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Takahiko Nagase, Nikolaos Tsianakas, Laura Perrotta, K R Julian Chun
BACKGROUND: The LAmbre™ occluder is a novel device for percutaneous left atrial appendage closure (LAAC). The presented study aimed to report the initial experience in implantation of the novel LAmbre for LAAC in patients with nonvalvular AF. METHODS: We conducted a prospective, observational, cohort registry study to evaluate the feasibility of percutaneous LAAC using the LAmbre system. RESULTS: Thirty patients (15 female, mean age 77.6 ± 8...
February 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29122931/outcome-of-left-atrial-appendage-occlusion-in-high-risk-patients
#12
Ahmed Masoud, Stefano Bartoletti, Timothy Fairbairn, Ayush Khurana, Periaswamy Velavan, William Lindsay Morrison, Afshin Khalatbari, Suneil Aggarwal, Nikhill Sharma, Paulus Kirchhof, Dhiraj Gupta
OBJECTIVE: Percutaneous left atrial appendage (LAA) occlusion can be an interventional alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. METHODS: We delivered LAA occlusion therapy using a standardised approach to patient referral, multidisciplinary team assessment, implant criteria, imaging and follow-up. We analysed patient characteristics, efficacy and safety of the implant procedure, and 12-month outcomes. RESULTS: Of 143 referrals from October 2014 to December 2016, 83 patients (age 76±8 years, 32...
November 9, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29122133/percutaneous-left-atrial-appendage-closure-with-the-lambre-device-for-stroke%C3%A2-prevention-in-atrial-fibrillation-a-prospective-multicenter-clinical-study
#13
He Huang, Yu Liu, Yawei Xu, Zulu Wang, Yigang Li, Kejiang Cao, Shu Zhang, Yanzong Yang, Xinchun Yang, Dejia Huang, Bo Yu, Xi Su, Liqun Wu, Congxin Huang
OBJECTIVES: The authors sought to assess the clinical outcomes of left atrial appendage (LAA) closure with the LAmbre closure system in patients with nonvalvular atrial fibrillation (NVAF). BACKGROUND: Over 90% of thrombi are located in the LAA in NVAF patients. METHODS: A prospective, multicenter study was conducted in 153 NVAF patients with CHADS2 score ≥1. RESULTS: The LAA was successfully occluded in 152 patients...
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29101544/anatomy-of-the-atria-a-road-map-to-the-left-atrial-appendage
#14
REVIEW
Umberto Barbero, Siew Yen Ho
The left atrial appendage (LAA) has received increasing attention in recent years because of thrombi formation in patients with atrial fibrillation, which increases the risk of stroke. In patients who have contraindications for long-term oral anticoagulation therapy, percutaneous procedures are used to occlude the LAA and there are now several devices available for implantation, both endocardially and epicardially. Despite the high-resolution imaging techniques on hand today, limitations remain in providing information about wall thickness and neighboring structures; therefore, in-depth knowledge of the normal atrial anatomy is mandatory when considering such interventions...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29080014/-available-transvenous-occluder-designs-and-implantation-techniques
#15
REVIEW
P Sick, T Lewalter
In this article, most of the present or available in the near future left atrial appendage (LAA) occlusion devices are discussed in terms of structure of the devices and principle technique for implantation. Thus, the Watchman™ device from Boston, the Amulet™ device from Abbot, the Lambre™ device from Lifetech, the Occlutech® device from Occlutech®, and the WaveCrest® device from Biosense Webster (former Coherex) are discussed. The systems differ in terms of the concept of occlusion. Several devices consist of only one part (Watchman™ and Occlutech®) that is implanted in the body, ending up in the orifice of the LAA...
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29071390/-current-indications-for-left-atrial-appendage-occlusion
#16
REVIEW
Clemens Jilek, Thorsten Lewalter
Among patients with atrial fibrillation, the bleeding risk is linked to the stroke risk. Left atrial appendage (LAA) occlusion may reduce bleeding risk in high-risk patients. On the basis of a literature analysis and the Consensus Document of European Heart Rhythm Association (EHRA), the indications for a LAA occluder are clarified and a clear decision strategy for daily clinical practice is presented.
December 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29047250/simultaneous-closure-of-a-left-atrial-appendage-through-an-atrial-septal-defect-and-the-atrial-septal-defect
#17
Shinjeong Song, Oh Hyun Lee, Jung Sun Kim, In Jeong Cho, Chi Young Shim, Geu Ru Hong, Hui Nam Pak, Yangsoo Jang
Left atrial appendage (LAA) occlusion can be employed as an alternative treatment to oral anticoagulation in patients with atrial fibrillation to prevent embolic events. Atrial septal defect (ASD) may be related with right heart dysfunction and allow paradoxical embolism to occur. However, occlusion of both LAA through atrial access with ostium secundum ASD and ASD in the same setting is unusual. Therefore, we report a case in which a LAA and an ASD was sequentially occluded.
November 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29016910/left-atrial-appendage-occluder-implantation-in-europe-indications-and-anticoagulation-post-implantation-results-of-the-european-heart-rhythm-association-survey
#18
Roland Richard Tilz, Tatjana Potpara, Jian Chen, Dan Dobreanu, Torben Bjerregaard Larsen, Kristina Herman Haugaa, Nikolaos Dagres
The aim of this EP Wire survey was to assess the indications and anticoagulation strategies post-left atrial appendage occluder (LAAO) implantation for stroke prevention in patients with non-valvular atrial fibrillation in Europe. A total of 33 centres in 13 European countries completed the survey. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Left atrial appendage occluder procedures were performed by electrophysiologists in 52% of the centres and by interventional cardiologists in the remaining centres...
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28716089/greater-periventricular-white-matter-hyperintensity-severity-in-basilar-artery-branch-atheromatous-disease
#19
Po-Chen Lin, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Yung-Yang Lin, Chih-Ping Chung
BACKGROUND: Basilar artery branch atheromatous disease (BABAD), in which basilar artery atheroma occludes penetrating arteries at their origin, is a common etiology of posterior circulation stroke (PCS). It is currently unknown whether white matter hyperintensity(WMH), a marker of small vessel disease(SVD), is associated with BABAD. METHODS: The present study analyzed data from patients with PCS who were enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and February 28, 2014...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28675629/long-term-follow-up-after-left-atrial-appendage-occlusion-with-comparison-of-transesophageal-echocardiography-versus-computed-tomography-to-guide-medical-therapy-and-data-about-postclosure-cardioversion
#20
Benjamin Berte, Christine Attenhofer Jost, Dominik Maurer, Anja Fäh-Gunz, Xavier Pillois, Barbara Naegeli, Monica Pfyffer, Gabor Sütsch, Christoph Scharf
AIMS: The use of left atrial appendage (LAA) occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice flow and outcome of electrical cardioversion (ECV) in these patients. METHODS AND RESULTS: Single-center prospective registry from 2009 to 2015 including all LAA occluders to analyze success and complications during implantation and follow-up...
October 2017: Journal of Cardiovascular Electrophysiology
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