Anesthesia and Transesophageal Echocardiography for WATCHMAN Device Implantation

Mitrev, Ludmil; Trautman, Natalie; Vadlamudi, Ratna K.; Desai, Nayan; Sabir, Sajjad

doi:10.1053/j.jvca.2016.06.012

Cited by 13 publications

(17 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LAA orifice, neck, and depth are usually measured using four 2D TEE views: 0° to 20° in the midesophageal (ME) 4-chamber view, 45° to 60° in ME aortic valve view; 90° in ME 2-chamber view, and 120° to 135° in the aortic valve long-axis view. 7 Here, the differences between the WATCHMAN and AMPLATZER Amulet should be recognized before obtaining proper measurements. The former device is available in 5 sizes (21 to 33 mm) and requires LAA ostial measurements between 17 and 31 mm for successful implantation, whereas the AMPLATZER Amulet comes in 7 sizes and can be used for landing zone widths between 11 and 31 mm ( Table 1).…”

Section: Preimplantation Echocardiographymentioning

confidence: 99%

“…21 For the WATCHMAN device, the orifice width (landing zone) is measured by the distance from the coronary artery marker or top of the mitral valve annulus to a point 2 cm from the tip of the limbus. 7 Depth or usable length is measured by a perpendicular line drawn between the ostium and the apex of the main lobe of the LAA. For the AMPLATZER Amulet device, LAA orifice width is measured by the length of the line between the circumflex artery and the superior rim of the pulmonary vein ridge, and the landing zone width is measured by the length of a line drawn 1 cm below the orifice.…”

Section: Preimplantation Echocardiographymentioning

confidence: 99%

“…6 AF leads to a 5-fold increase in the risk of stroke, contributing to more than 20% of all stroke cases. 7 One of the goals of AF management is stroke prevention. AF stroke risk is stratified based on the commonly used CHA 2 DS 2 -VAS C score.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement

Subramaniam

Ibarra

Boisen

2018

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

In this report, we provided details of periprocedural echocardiographic guidance for patients undergoing Amplatzer-Amulet device left atrial closure. Familiarity with left atrial appendage (LAA) occlusion devices and the required left atrial examination and measurements are key before device placement. Device placement is assisted by transesophageal echocardiography (TEE) and fluoroscopy, but TEE will be the main guide for patients with renal insufficiency in whom contrast dye use needs to be minimal. TEE is also used to confirm LAA occlusion with the device and finally detect complications throughout the procedure and into the postoperative period.

show abstract

Section: Preimplantation Echocardiographymentioning

confidence: 99%

Section: Preimplantation Echocardiographymentioning

confidence: 99%

See 1 more Smart Citation

Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement

Subramaniam

Ibarra

Boisen

2018

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

show abstract

“…During LAAO, intraprocedural transesophageal echocardiography (TEE) is performed in all patients on a routine basis to guide the transseptal puncture[5] and to have a full view of the LAA, which is needed to obtain accurate measurements. [36]…”

Section: Introductionmentioning

confidence: 99%

“…As TEE assessment and immobility of the patients are key factors to the success and safety of the procedure, LAAO is usually performed under general anesthesia. [6] Unfortunately, patients undergoing LAAO are frequently old, frail and with several comorbidities. All these factors increase the risks of complications of general anesthesia, including pulmonary complications and cognitive decline.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive ventilation during left atrial appendage closure under sedation: Preliminary experience with the Janus Mask

et al. 2019

View full text Add to dashboard Cite

Background:Percutaneous left atrial appendage occlusion (LAAO) is indicated in subjects with atrial fibrillation who cannot receive oral anticoagulants. This procedure requires transesophageal echocardiography guidance and is usually performed under general anesthesia. The Janus Mask is a new device designed to allow upper endoscopic procedures during noninvasive ventilation (NIV).Aims:This study aims to assess the possibility of performing LAAO under sedation and NIV.Setting:Cardiac electrophysiology laboratory.Design:Case–control study.Materials and Methods:Data from 11 subjects undergoing LAAO under sedation and NIV with the Janus Mask were retrospectively collected. Procedure duration, outcomes, and physicians' satisfaction were compared with those of 11 subjects who underwent LAAO under general anesthesia in the same period.Statistical Analysis:Univariate analysis and analysis of variance for between-groups comparison.Results:The 11 subjects treated with sedation experienced a good outcome, with a high degree of satisfaction from the medical team. An increase in arterial partial pressure of carbon dioxide in the Janus group (45 [43–62] mmHg vs. 33 [30–35] mmHg in the general anesthesia group, P < 0.001) led to a transient pH decrease 45 min after the beginning of the procedure (7.30 [7.18–7.36] vs. 7.40 [7.39–7.46], P = 0.014). No differences in arterial partial pressure of oxygen, FiO2, and hemodynamic parameters were observed. The subjects' conditions at discharge from the recovery room were comparable. No difference in procedure duration was registered.Conclusions:LAAO procedure under sedation and NIV through the Janus Mask is safe and feasible. This strategy might represent a valuable alternative to manage such a compromised and fragile population.

show abstract

Intracardiac Masses, Devices, and Foreign Bodies

Gelfenbeyn

Choi

2022

Essential Echocardiography

View full text Add to dashboard Cite

Anesthesia and Transesophageal Echocardiography for WATCHMAN Device Implantation

Cited by 13 publications

References 33 publications

Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement

Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement

Noninvasive ventilation during left atrial appendage closure under sedation: Preliminary experience with the Janus Mask

Intracardiac Masses, Devices, and Foreign Bodies

Contact Info

Product

Resources

About