Initial Experience With a Novel Percutaneous Left Atrial Appendage Exclusion Device in Patients With Atrial Fibrillation, Increased Stroke Risk, and Contraindications to Anticoagulation

Massumi, Ali; Chelu, Mihail G.; Nazeri, Alireza; May, Stephen A.; Afshar-Kharaghan, Hamid; Saeed, Mohammad; Razavi, Mehdi; Rasekh, Abdi

doi:10.1016/j.amjcard.2012.11.061

Cited by 107 publications

(96 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This type of complication is not reported in previous larger series on percutaneous ligation of the LAA utilizing the same device. [6][7][8] The most common intraoperative complication seen in other series and case reports is right ventricular perforation during epicardial access or perforation of the LAA itself. [6][7][8][9] Three other cases at our institution were performed without complication by the same operators using an identical technique.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left Atrial Laceration With Epicardial Ligation Device

Keating¹,

Kolibash²,

Khandheria³

et al. 2014

ATCS

View full text Add to dashboard Cite

Many new devices and techniques are being developed to attempt a reduction in embolic stroke risk for patients with atrial fibrillation who are either unable or unwilling to maintain long-term anticoagulation. One of these new devices (LARIAT ® , SentreHEART Inc., Redwood City, California, USA) employs delivery of an epicardial suture to ligate the left atrial appendage after percutaneous pericardial and transseptal access. This series presents three clinical cases that demonstrate a serious and recurrent complication of left atrial laceration and cardiac tamponade shortly following delivery of an epicardial suture ligation to the left atrial appendage. Three clinical cases are described in detail with pre-and postprocedure angiography and echocardiography as well as illustrations reflecting the surgeon's findings on direct visualization of the left atrial lacerations postligation. Potential hypotheses of each injury are examined in light of the case timelines and findings at sternotomy. There was no suggestion that tamponade was related to pericardial or transseptal access, but rather a complication with device delivery. These three patients quickly progressed to clinical cardiac tamponade despite attempted drainage, stressing the importance of cardiovascular surgery backup, including a cardiopulmonary bypass pump, when delivering novel, percutaneous ligation devices for the left atrial appendage.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Further studies into the delivery design and technique of percutaneous LAA ligation are warranted, and increased experience with this device has already extended beyond the 137 cases referred to in this report. [6][7][8] …”

Section: Discussionmentioning

confidence: 99%

Left Atrial Laceration With Epicardial Ligation Device

Keating¹,

Kolibash²,

Khandheria³

et al. 2014

ATCS

View full text Add to dashboard Cite

show abstract

“…Serija sluËajeva koja je ukljuËivala 16 bolesnika je prikazala naËin koriπtenja Amplatzer septalnog zatvaraËa za zatvaranje LAA u lokalnoj anesteziji, bez ehokardigrafskog voenja. 13 Amplatzer kardijalni Ëep je drugi ureaj izraen posebno za zatvaranje LAA i u fazi je kliniË-kih ispitivanja. 14 Ovaj ureaj se bazira na nitinolu i sastoji se od lijevog atrijskog diska i distalnog Ëepa spojenog na lijevi atrijski disk kratkim strukom.…”

Section: Amplatzer Septalni Zatvaraë I Amplatzer Kardijalni ëEpunclassified

“…A case series involving 16 patients demonstrated the use of the Amplatzer septal occluder to close LAA under local anaesthesia without echocardiographic guidance. 13 The Amplatzer cardiac plug is another device designed specifically for closure of the LAA and is undergoing clinical trials. 14 This device is nitinol based and consists of a left atrial disk and a distal plug connected to the left atrial disk by a short waist.…”

Section: Intervencije Na Mitralnom Zaliskumentioning

confidence: 99%

Almanac 2013: novel non-coronary cardiac interventions

Meier

Franzen²,

Lansky³

2013

Cardiol Croat.

View full text Add to dashboard Cite

SAAEETAK:Aktualne inovacije u intervencijskoj kardiologiji dramatiËno su proπirile terapijske moguÊnosti za srËa-ne bolesnike. Intervencijska kardiologija viπe nije ograniËena na lijeËenje koronarne bolesti srca veÊ je moguÊe lijeËiti bolesti zalistaka, raditi na prevenciji moaedanog udara, lijeËenju arterijske hipertenzije, itd. Jedna od najvaaenijih novih moguÊnosti lijeËenja je perkutano lijeËenje aortne stenoze (transkateterska implantacija aortne valvule), buduÊi da je bolest aortne valvule vrlo Ëest problem u bolesnika starije aeivotne dobi, a mnogi od njih imaju visok rizik od operacije. Isto tako, mitralna regurgitacija je Ëesto povezana s pojavom komorbiditeta koji Ëine operaciju visokoriziËnom. MitraClip je obeÊavajuÊe perkutano alternativno rjeπenje za kirurπki popravak ili zamjenu srËanog zaliska. Ostali postupci koji se spominju u ovom preglednom Ëlanku su perkutano zatvaranje aurikule lijevog atrija kao nefarmakoloπka terapija za prevenciju moaedanog udara, renalna denervacija za rezistentnu arterijsku hipertenziju. U ovom se Ëlanku pojaπnjavaju osnovni principi ovih postupaka, najvaaenije kliniËke studije uz dodatne kliniËke podatke o svakom od njih. KLJU»NE RIJE»I: intervencijska kardiologija, intervencijski zahvati na zaliscima. SUMMARY:Recent innovations in interventional cardiology have dramatically expanded the therapeutic options for patients with cardiac conditions. Interventional cardiology is no longer limited to the treatment of coronary artery disease but allows also treatment of valvular disease, stroke prevention, hypertension, etc. One of the most important new treatment options is the percutaneous treatment for aortic valve stenosis (transcatheter aortic valve implantation), since aortic valve disease is a rather common problem in elderly patients, with many of them at high risk for surgery. Similarly, mitral regurgitation is often associated with comorbidities which make surgery high risk. The MitraClip is a promising percutaneous alternative to surgical valve repair or replacement. Other procedures discussed in this review are the percutaneous left atrial appendage closure as a non-pharmacologic therapy to prevent strokes, and renal denervation for resistant hypertension. This review explains the basic principles of these procedures, the most important clinical evidence, and also provides additional recent clinical data on each of these them.

show abstract

“…These concerns were reproduced by two studies including 20 and 27 patients, respectively, that reported myocardial punctures requiring further procedures. 8,9 Each of the two studies also reported three patients who presented with severe postprocedural pericarditis, necessitating hospital stays and in one instance coronary angiography. Although the Lariat is a novel idea, we believe these events should raise questions about the safety of its use in this particular indication of LAA occlusion.…”

Section: Introductionmentioning

confidence: 99%