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Appendage closure

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https://www.readbyqxmd.com/read/28649053/left-atrial-appendage-occlusion-with-the-amplatzer-amulet-device-periprocedural-and-early-clinical-echocardiographic-data-from-a-global-prospective-observational-study
#1
Ulf Landmesser, Boris Schmidt, Jens Erik Nielsen-Kudsk, Simon Cheung Chi Lam, Jai-Wun Park, Giuseppe Tarantini, Ignacio Cruz-Gonzalez, Volker Geist, Paolo Della Bella, Antonio Colombo, Tobias Zeus, Heyder Omran, Christopher Piorkowski, Juha Lund, Claudio Tondo, David Hildick-Smith
AIMS: The global, prospective AMPLATZER Amulet observational study documents real-world periprocedural, transoesophageal echocardiographic (TEE) and clinical outcomes from left atrial appendage occlusion (LAAO) using the AMPLATZER Amulet device. The aim of this report is to describe the periprocedural and early clinical/TEE results from this study. METHODS AND RESULTS: This multicentre prospective real-world registry included 1,088 patients (75±8.5 years, 64.5% male, CHA2DS2-VASc: 4...
June 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28648669/ewolution-the-next-evolution-in-appendage-closure
#2
EDITORIAL
Muhammad R Afzal, Emile G Daoud
No abstract text is available yet for this article.
June 22, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28633397/impact-of-a-refined-advanced-design-for-left-atrial-appendage-exclusion
#3
Gengo Sunagawa, Jamshid H Karimov, May Breitbach, Nicholas A Robinson, Kiyotaka Fukamachi
OBJECTIVES: Exclusion of the left atrial appendage has been proposed to reduce the risk of stroke in patients with atrial fibrillation. The aim of this study was to evaluate the feasibility and efficacy of the AtriClip PRO·V device (AOD2), now in development, for left atrial appendage exclusion in a canine model. METHODS: The newest AtriClip design comprises a dual-spring mechanism that allows the clip to open into a 'V' shape while still providing equivalent force along the length of the beam...
June 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#4
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28625383/the-assessment-of-the-watchman-device-in-patients-unsuitable-for-oral-anticoagulation-asap-too-trial
#5
David R Holmes, Vivek Y Reddy, Maurice Buchbinder, Kenneth Stein, Myriah Elletson, Martin W Bergmann, Boris Schmidt, Jacqueline Saw
BACKGROUND: Oral anticoagulants (OACs) reduce stroke risks with nonvalvular atrial fibrillation (AF); however, they are underused because of absolute or relative contraindications due to real or perceived risk of bleeding. Although left atrial appendage closure is increasingly performed in OAC-ineligible patients, this has not been studied in a randomized controlled trial. STUDY OBJECTIVES: The ASAP-TOO study is designed to establish the safety and effectiveness of the Watchman left atrial appendage closure device in patients with nonvalvular AF who are deemed ineligible for OAC...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28606886/early-anticoagulation-drug-regimens-after-watchman-left-atrial-appendage-closure-safety-and-efficacy
#6
Martin W Bergmann, Timothy R Betts, Horst Sievert, Boris Schmidt, Evgeny Pokushalov, Stephan Kische, Thomas Schmitz, Felix Meincke, Kenneth M Stein, Lucas V Boersma, Hüseyin Ince
AIMS: While LAA closure has recently been incorporated in both European and US guidelines for stroke prevention, uncertainties regarding post-procedural drug therapy so far limit its adoption. METHODS AND RESULTS: 1005 patients were implanted with a WATCHMAN device in the prospective EWOLUTION study at 47 centers. 73.5% of the patients were deemed contraindicated for long-term OAC therapy. Here we report on 3-months data including the first follow-up TOE exam for 94% of the study population...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28595810/successful-percutaneous-retrieval-of-embolized-transcatheter-left-atrial-appendage-closure-device-watchman-using-a-modified-vascular-retrieval-forceps
#7
Zaher Fanari, Sachin Goel, Jeffrey A Goldstein
Transcatheter closure of the left atrial appendage (LAA) is increasingly considered as an alternative to oral anticoagulation in patients with previous major bleeding or at high-risk of bleeding. Device embolization with transcatheter LAA closure is a rare complication. Most cases are asymptomatic, but it can be life threatening. Depending on the location of embolization, percutaneous retrieval is feasible. Snares are usually used for retrieval, but other devices may be used. We report the case of a 63-year gentleman who underwent an uneventful LAA closure with Watchman device and routine testing next day showed embolization to the abdominal aorta...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28595459/percutaneous-closure-of-the-left-atrial-appendage-in-patients-with-diabetes-mellitus
#8
Obayda Azizy, Christos Rammos, Nils Lehmann, Tienush Rassaf, Hagen Kälsch
BACKGROUND: Left atrial appendage closure is a preventive treatment of atrial fibrillation-related thrombo-embolism. Patients with diabetes mellitus have increased risk for a negative outcome in percutaneous cardiac interventions. We assessed whether percutaneous left atrial appendage closure is safe and effective in patients with diabetes mellitus. METHODS: We included 78 patients (mean age of 74.4 ± 8.3 years) with indication for left atrial appendage closure in an open-label observational single-centre study...
June 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28594903/the-role-of-bone-marrow-mesenchymal-stromal-cell-derivatives-in-skin-wound-healing-in-diabetic-mice
#9
Tomas de Mayo, Paulette Conget, Silvia Becerra-Bayona, Claudia L Sossa, Virgilio Galvis, Martha L Arango-Rodríguez
Mesenchymal stromal cells (MSCs) have shown to be a promising tool in cell therapies to treat different conditions. Several pre-clinical and clinical studies have proved that the transplantation of MSCs improves wound healing. Here, we compare the beneficial effects of mouse bone marrow-derived allogeneic MSCs (allo-mBM-MSCs) and their acelullar derivatives (allo-acd-mMSCs) on skin wound healing in Non-Obese Diabetic (NOD) mice. One dose of allo-mBM-MSCs (1×106 cells) or one dose of allo-acd-mMSCs (1X) were intradermally injected around wounds in 8-10 week old female NOD mice...
2017: PloS One
https://www.readbyqxmd.com/read/28577840/efficacy-and-safety-of-left-atrial-appendage-closure-with-watchman-in-patients-with-or-without-contraindication-to-oral-anticoagulation-1-year-follow-up-outcome-data-of-the-ewolution-trial
#10
Lucas V Boersma, Hueseyin Ince, Stephan Kische, Evgeny Pokushalov, Thomas Schmitz, Boris Schmidt, Tommaso Gori, Felix Meincke, Alexey Vladimir Protopopov, Timothy Betts, David Foley, Horst Sievert, Patrizio Mazzone, Tom De Potter, Elisa Vireca, Kenneth Stein, Martin W Bergmann
BACKGROUND: Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. OBJECTIVE: EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry. METHODS: A total of 1025 patients scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers. Indication for LAA closure was based on European Society of Cardiology guidelines...
May 31, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28570323/neurologic-complications-of-cardiac-and-aortic-disease
#11
James P Klaas
PURPOSE OF REVIEW: This article discusses neurologic complications that can arise from cardiac and aortic disease and dysfunction. RECENT FINDINGS: Advances in the care of patients with cardiac or aortic disease include the use of prolonged cardiac monitoring in cryptogenic stroke and the approval of the use of left atrial appendage closure devices for stroke prevention in patients with atrial fibrillation who are not candidates for anticoagulation. Continuing controversy surrounds patent foramen ovale closure, and new evidence indicates that cognitive impairment following coronary artery bypass grafting surgery may be less common than previously thought...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28565887/safety-and-efficacy-of-catheter-based-left-atrial-appendage-closure-in-patients-with-contraindications-for-long-term-anticoagulation
#12
Adrian Seidel, Abdul S Parwani, Florian Krackhardt, Martin Huemer, Philipp Attanasio, Wilhelm Haverkamp, Burkert Pieske, Leif-Hendrik Boldt
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) and the role of post interventional anticoagulation often evokes controversy in daily practice. This study aimed to evaluate LAAC in patients with non-rheumatic atrial fibrillation, high thromboembolic risk and contraindications for long-term anticoagulation in a clinical scenario. METHODS AND RESULTS: Between 2010-2015, LAAC was attempted in 118 patients (47 women). Devices were successfully implanted in 95% (Watchman™ device n=97, St...
May 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28560785/image-of-a-left-atrial-mass-after-a-cardiopulmonary-bypass-in-a-child
#13
Khaled Hadeed, Bertrand Leobon, Yves Dulac, Philippe Acar
Invagination of an appendage into the left atrium is a rare complication. It occurs spontaneously or after open-heart surgery. In our case, a postoperative transesophageal echocardiogram, after closure of a ventricular septal defect in a 5-month-old infant, revealed a large mass in the left atrium. A diagnosis of a left appendage inversion was confirmed after external examination of the heart. Herein, we provide echocardiographic images before, during, and after manual reversion of the left appendage. Misdiagnosis of this complication could have led to an additional unnecessary surgical procedure that could have impacted on the patient's morbidity...
May 30, 2017: Echocardiography
https://www.readbyqxmd.com/read/28558866/potential-clinical-utility-and-feasibility-of-combined-left-atrial-appendage-closure-and-positioning-of-miniaturized-pacemaker-through-a-single-right-femoral-vein-access
#14
François Regoli, Marco Araco, Tiziano Moccetti, Maria Luce Caputo, Giulio Conte, Angelo Auricchio, Marco Moccetti
This study assessed the clinical utility and feasibility of concomitant of combined left atrial appendage (LAA) closure and positioning of miniaturized pacemaker (Micra TPS). All consecutive patients who underwent VVI-PM implant from November 2015 to October 2016 were considered. VVI-PM implant was conducted either using transvenous approach or by positioning Micra TPS. In selected patients with concomitant contraindication to OAC, Micra TPS was combined with LAA occlusion ("combined approach"), performed in general anesthesia and guided by multimodality imaging; procedural and follow-up data of these specific patients were registered...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28504238/united-kingdom-coronary-and-structural-heart-interventions-from-2010-to-2015
#15
Peter F Ludman, Mark A de Belder, Simon Redwood, Adrian Banning
In the United Kingdom, a clinical data set is completed for every patient undergoing coronary intervention and certain structural interventions, and sent to central servers in the National Institute for Cardiovascular Outcomes Research (NICOR) on behalf of the British Cardiovascular Intervention Society (BCIS). These data are linked to the national mortality register. In addition, data are obtained about the structure of healthcare provision using an annual survey. Analyses of these data are provided for different audiences in several formats...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504234/spain-coronary-and-structural-heart-interventions-from-2010-to-2015
#16
Bruno García Del Blanco, Pilar Jiménez Quevedo, José D Diaz, Felipe Hernández, José Ramón Rumoroso, Manel Sabaté, José Maria de la Torre Hernandez, Ana Serrador, Armando Pérez de Prado, Javier Goicolea, Ramiro Trillo, Manolo Pan
Since 1990 The Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology has presented a yearly report on the data collected in the National Registry, with online support since 2010. The Steering Committee has analysed all data provided voluntarily by institutions, which consisted of a total of anywhere between 105 and 113 hospitals. Medical care was provided to a population of 46.8 million inhabitants in 2015. During this period, diagnostic procedures increased progressively from 2010, reaching a maximum of 145,836 in 2015, 86% (125,484) corresponding to coronary angiograms...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504231/poland-coronary-and-structural-heart-interventions-from-2010-to-2015
#17
Jacek Legutko, Zbigniew Siudak, Radosław Parma, Andrzej Ochała, Dariusz Dudek
For the last five years, invasive cardiology in Poland has developed extensively. Currently, 98% of the 161 Polish cathlabs operate in 24/7 mode, 37 of them supported by cardiac surgery departments on-site. A certification curriculum for interventional cardiology operators is supported by dedicated workshops and scientific meetings during national conferences. The rise in the number of coronary angiographies and PCIs was paralleled by an increased use of drug-eluting stents, bioresorbable vascular scaffolds and physiologic assessment of coronary arteries...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28496929/management-of-patients-with-atrial-fibrillation-focus-on-treatment-options
#18
REVIEW
Pawel Matusik, Jacek Lelakowski, Barbara Malecka, Jacek Bednarek, Remigiusz Noworolski
Atrial fibrillation (AF) is leading cardiac arrhythmia with important clinical implications. Its diagnosis is usually made on the basis on 12-lead ECG or 24-hour Holter monitoring. More and more clinical evidence supports diagnostic use of cardiac event recorders and cardiovascular implantable electronic devices (CIED). Treatment options in patients with atrial fibrillation are extensive and are based on chosen rhythm and/or rate control strategy. The use and selected contraindications to AF related pharmacotherapy, including anticoagulants are shown...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28495432/changes-in-coagulation-and-platelet-activation-markers-following-transcatheter-left-atrial-appendage-closure
#19
Josep Rodés-Cabau, Gilles O'Hara, Jean-Michel Paradis, Mathieu Bernier, Tania Rodriguez-Gabella, Ander Regueiro, Kim O'Connor, Jonathan Beaudoin, Rishi Puri, Mélanie Côté, Jean Champagne
The recommendations for antithrombotic treatment after left atrial appendage closure (LAAC) remain empirical, and no data exist on the changes in hemostatic markers associated with LACC. The objective of the present study is to determine the presence, degree, and timing of changes in the markers of platelet and coagulation activation after LAAC. Forty-three patients (mean age 76 ± 9 years, 23 men) with atrial fibrillation who underwent successful LACC with the Watchman (n = 27) or Amplatzer Cardiac Plug (n = 16) devices were included in the study...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#20
Julia Seeger, Ralf Birkemeyer, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. METHODS AND RESULTS: Twelve consecutive non-valvular atrial fibrillation patients (age 76.6±7.8years) at high risk for stroke (CHA2DS2-VASc-Score 5.5±0.9) and bleeding (HAS-BLED-Score 3.8±0.9), received LAA closure with the Watchman FLX...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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