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Appendage closure

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https://www.readbyqxmd.com/read/28228166/methylene-blue-assay-for-estimation-of-regenerative-re-epithelialization-in-vivo
#1
Maresha Milyavsky, Renee Dickie
The rapidity with which epithelial cells cover a wound surface helps determine whether scarring or scar-less healing results. As methylene blue is a vital dye that is absorbed by damaged tissue but not undamaged epidermis, it can be used to assess wound closure. We sought to develop a quantitative methylene blue exclusion assay to estimate the timeframe for re-epithelialization in regenerating appendages in zebrafish and axolotls, two classic model systems of regeneration. Following application of methylene blue to the amputation plane and extensive washing, the regenerating tail was imaged in vivo until staining was no longer visible...
February 2017: Microscopy and Microanalysis
https://www.readbyqxmd.com/read/28225286/-closure-of-the-left-atrial-appendage-by-means-of-the-atriclip-system
#2
Aleš Mokráček, Vojtěch Kurfirst, Alan Bulava, Jiří Haniš
INTRODUCTION: Atrial fibrillation (AFib) is related to a high risk of stroke. The main role in etiopathogenesis is played by the left atrial appendage (LAA). As many as 95 % of thrombi in nonvalvular atrial fibrillation are located in the appendage. Prevention of stroke then consists in permanent anticoagulation which, however, has its limits and risks. An alternative method is the left atrial appendage occlusion. In our report, we would like to present a new possibility of the closure using the epicardial system AtriClip (AtriCure)...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28218603/frequency-and-clinical-course-of-cerebral-embolism-in-patients-undergoing-transcatheter-left-atrial-appendage-closure
#3
Nicolas Majunke, Franziska Eplinius, Matthias Gutberlet, Sven Moebius-Winkler, Ingo Daehnert, Matthias Grothoff, Stephan Schürer, Norman Mangner, Philipp Lurz, Sandra Erbs, Katharina Kirsch, Gerhard Schuler, Marcus Sandri
AIMS: To assess silent and clinically apparent cerebral embolic events in patients undergoing transcatheter left atrial appendage closure. METHODS AND RESULTS: In this prospective single-center study 28 patients underwent percutaneous closure of the left atrial appendage. In all patients a diffusion-weighted magnetic resonance imaging (DWI-MRI) study was performed before, the day after the procedure and during routine follow-up after 45 days. All patients underwent neurological assessment at the time of DWI-MRI...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#4
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#5
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28188931/percutaneous-left-atrial-appendage-closure-improves-left-atrial-mechanical-function-through-frank-starling-mechanism
#6
Augustin Coisne, Rosario Pilato, François Brigadeau, Didier Klug, Christelle Marquie, Zouheir Souissi, Marjorie Richardson, Stéphanie Mouton, Anne-Sophie Polge, Patrizio Lancellotti, Dominique Lacroix, David Montaigne
BACKGROUND: Modifications in left atrial (LA) flow velocities after left atrial appendage (LAA) exclusion have been shown in animal and ex vivo models. In a substudy of the PROTECT AF, an objective improvement in quality of life was observed after LAA closure. OBJECTIVE: We aimed to investigate the impact of LAA closure on LA transport function METHODS: Comprehensive Transthoracic echocardiography (TTE) evaluation (2D/3D, 2D speckle tracking) was prospectively performed before and after LAA closure (at discharge and 45 days after procedure) in 33 patients...
February 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28183749/rapid-and-affordable-3-dimensional-prototyping-for-left-atrial-appendage-closure-planning
#7
Houman Khalili, Ralph E Gentry, Melissa A Stevens, Steven L Almany, Subhash Banerjee, David E Haines, George S Hanzel
No abstract text is available yet for this article.
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28181272/left-atrial-appendage-closure-for-stroke-prevention-more-choice-is-always-a-good-thing
#8
EDITORIAL
Rong Bai
While oral anticoagulants (OACs) remains the main strategy of prevention of thromboembolic event in patients with atrial fibrillation (AF), left atrial appendage closure (LAAC) has become an alternative recently. The concept of this technique is based on the understanding that in more than 90% non-valvular AF patients, the thrombi form in the left atrial appendage (LAA), so excluding the LAA from the systemic circulation can prevent stroke or peripheral arterial embolization. To achieve this goal, novel trans-catheter techniques have been developed to either occlude the LAA endocardially or ligate the LAA epicardially...
February 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28174408/-double-valve-replacement-and-tricuspid-annuloplasty-in-a-patient-with-situs-inversus-totalis-and-mirror-image-dextrocardia-report-of-a-case
#9
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi, Kazuhito Tatsu
Situs inversus totalis and mirror-image dextrocardia is a rare congenital anomaly. A 79-year-old man with a history of atrial fibrillation presented to our hospital with chest oppression. Chest X-ray and computed tomography showed mirror-image dextrocardia and situs inversus totalis. Echocardiography revealed severe mitral and aortic regurgitation and mild tricuspid regurgitation. Mitral and aortic valve replacement using bioprosthesises, tricuspid annuloplasty and closure of the left atrial appendage were successfully performed...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28149625/five-years-of-keeping-a-watch-on-the-left-atrial-appendage-how-has-the-watchman-fared
#10
COMMENT
Mohammad-Ali Jazayeri, Venkat Vuddanda, Valay Parikh, Madhav Lavu, Donita Atkins, Y Madhu Reddy, Jayant Nath, Dhanunjaya R Lakkireddy
Left atrial appendage closure (LAAC) is a promising site-directed therapy for stroke prevention in patients with non-valvular atrial fibrillation (AF) who are ineligible or contraindicated for long-term oral anticoagulation. A variety of LAAC modalities are available, including percutaneous endocardial occluder devices such as WATCHMAN(TM) (Boston Scientific Corp., Marlborough, MA, USA), and an ever-increasing body of evidence is helping to define the optimal use of each technique. Similarly increased experience with LAAC has revealed challenges such as device-related thrombi and peri-device leaks for which the long-term significance and appropriate management are areas of active investigation...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28129320/totally-endoscopic-robotic-left-atrial-appendage-closure-demonstrates-high-success-rate
#11
Alison F Ward, Robert M Applebaum, Nana Toyoda, Ans Fakiha, Peter J Neuburger, Jennie Ngai, Robert G Nampiaparampil, David W Yaffee, Didier F Loulmet, Eugene A Grossi
OBJECTIVE: In patients with atrial fibrillation, 90% of embolic strokes originate from the left atrial appendage (LAA). Successful exclusion of the LAA is associated with a lower stroke rate in patients with atrial fibrillation. Surgical oversewing of the LAA is often incomplete when evaluated with transesophageal echocardiogram (TEE). External closure techniques of suturing and stapling have also demonstrated high failure rates with persistent flow and large stumps. We hypothesized that the precise visualization of a robotic LAA closure (RLAAC) would result in superior closure rates...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28128883/early-canadian-multi-center-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#12
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There is limited data with WATCHMAN for left atrial appendage (LAA) closure in patients with non-valvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at 4 major Canadian centers. Indications for LAA closure were CHADS2 ≥ 1 or CHA2 DS2 -VASc ≥ 2, and contraindication/intolerance to or failure on anticoagulation...
January 27, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28121919/roles-of-real-time-three-dimensional-transesophageal-echocardiography-in-peri-operation-of-transcatheter-left-atrial-appendage-closure
#13
Qing Zhou, Hongning Song, Lan Zhang, Qing Deng, Jinling Chen, Bo Hu, Yijia Wang, Ruiqiang Guo
Left atrial appendage (LAA) closure is a new treatment option for the prevention of stroke in patients with nonvalvular atrial fibrillation (AF). Conventional 2-dimensional transesophageal echocardiography (2D TEE) has some limitations in the imaging assessment of LAA closure. Real-time 3-dimensional transesophageal echocardiography (RT-3D TEE) allows for detailed morphologic assessment of the LAA. In this study, we aim to determine the clinical values of RT-3D TEE in the periprocedure of LAA closure.Thirty-eight persistent or paroxysmal AF patients with indications for LAA closure were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28089095/characteristics-of-anatomy-and-function-of-the-left-atrial-appendage-and-their-relationships-in-patients-with-cardioembolic-stroke-a-3-dimensional-transesophageal-echocardiography-study
#14
Yuki Matsumoto, Yoshihiro Morino, Akiko Kumagai, Maiko Hozawa, Motoyuki Nakamura, Yasuo Terayama, Atsushi Tashiro
BACKGROUND: Increasing attention is being paid to the left atrial appendage (LAA) in the context of risk stratification in cardioembolic stroke (CES) and the requirement for meticulous planning of percutaneous closure device implantation. However, detailed systematic assessment of the LAA remains limited. METHODS: This study evaluated the anatomy and function of LAA using 3-dimensional transesophageal echocardiography (3D-TEE) on 194 consecutive patients older than 50 years old hospitalized exclusively for CES...
January 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28077818/enlargement-of-the-excluded-left-atrial-appendage-with-thrombus
#15
Shigeaki Aoyagi, Satoru Tobinaga, Hiroyuki Saisho
We report progressive enlargement of the excluded left atrial appendage (LAA) with a thrombus in a patient who had undergone valve surgery and endocardial suture closure of the LAA previously. Echocardiography and CT detected no communication between the LAA and the left atrium. Magnetic resonance imaging showed the LAA was filled with fresh and old thrombi. Coronary arteriography demonstrated small left coronary artery-LAA fistulae. At surgery, successful exclusion of the LAA was confirmed after removal of the thrombi...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077177/transcatheter-closure-of-secundum-atrial-septal-defects-has-fear-of-device-erosion-altered-outcomes
#16
Bryan Mitchelson, Clare O'Donnell, Peter Ruygrok, John Wright, John Stirling, Nigel Wilson
BACKGROUND: Transcatheter device closure has become the established standard of care for suitable atrial septal defects. Device erosion has been a recent focus and has prompted changes in the Instructions for Users documentation released by device companies. We reviewed our entire local experience with atrial septal defect device closure, focussing on the evolution of this procedure in our centre and particularly on complications. METHODS: We carried out a retrospective review of 581 consecutive patients undergoing attempted transcatheter device closure of an atrial septal defect in Auckland from December 1997 to June 2014...
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28073645/percutaneous-closure-of-a-whale-tail-left-atrial-appendage
#17
Xavier Freixa, Alejandro Panaro, Julio Carballo
No abstract text is available yet for this article.
January 7, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28065447/percutaneous-left-atrial-appendage-closure-followed-by-single-antiplatelet-therapy-short-and-mid-term-outcomes
#18
Zakaria Jalal, Marie-Lou Dinet, Nicolas Combes, Xavier Pillois, Pauline Renou, Igor Sibon, Xavier Iriart, Jean-Benoît Thambo
BACKGROUND: After left atrial appendage closure (LAAC), various antithrombotic protocols have been suggested, but the optimal post-procedural antithrombotic strategy is still under debate. AIMS: To investigate the efficacy and safety of LAAC with an AMPLATZER™ Cardiac Plug (ACP) device (St. Jude Medical, Minneapolis, MN, USA) followed by single antiplatelet therapy. METHODS: Consecutive patients with non-valvular atrial fibrillation and a contraindication for oral anticoagulants who underwent LAAC with an ACP device between 2012 and 2014 in two French centres were included...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28057291/successful-retrieval-of-a-dislodged-left%C3%A2-atrial-appendage-closure-device
#19
Oh-Hyun Lee, Hancheol Lee, Jung-Sun Kim
No abstract text is available yet for this article.
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28041899/left-atrial-appendage-closure-in-patients-with-atrial-fibrillation-and-previous-intracerebral-hemorrhage
#20
Pauline Renou, Jean-Benoît Thambo, Xavier Iriart, Stéphanie Nicot, Nathanael Kabore, Zakaria Jalal, Stéphane Olindo, Sabrina Debruxelles, Mathilde Poli, François Rouanet, Igor Sibon
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) may be considered in patients with atrial fibrillation and contraindication for long-term anticoagulation. This study aimed to assess the safety and efficacy of LAAC followed by single antiplatelet therapy in patients with atrial fibrillation and previous spontaneous intracerebral hemorrhage (ICH). METHODS: In this explorative, prospective, single-center study, consecutive patients who underwent LAAC because of previous spontaneous ICH over a period of 4 years were analyzed...
December 30, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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