Late clinical outcomes of lambre versus amplatzer occluders for left atrial appendage closure

Schnupp, Steffen; Liu, Xiaoxia; Buffle, Eric; Gloekler, Steffen; Mohrez, Yamen; Cheikh-Ibrahim, Mohammad; Allakkis, Wasim; Brachmann, Johannes; Park, Jai‐Wun; Kleinecke, Caroline

doi:10.1111/jce.14398

Cited by 16 publications

(26 citation statements)

References 32 publications

(80 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A comparação entre o LAmbre e o Amplatzer mostrou eficácia em longo prazo e segurança similares em pacientes com FANV. 20,21 Os resultados imediatos e tardios do presente estudo estão de acordo com a literatura disponível. A taxa aceitável das complicações do procedimento e o seguimento favorável desta coorte de pacientes (de alto risco e com condição complexa) é encorajadora.…”

Section: Discussionunclassified

Oclusão do Apêndice Atrial Esquerdo com a Prótese Lambre: Experiência Multicêntrica Inicial no Brasil

Chamié¹,

Guérios²,

Peralta³

et al. 2022

Arquivos Brasileiros De Cardiologia

View full text Add to dashboard Cite

Resumo Fundamento A oclusão do apêndice atrial esquerdo (AAE) tem se mostrado uma alternativa à terapia de anticoagulação oral (ACO) para prevenção de acidente vascular cerebral (AVC) em pacientes com fibrilação atrial não valvar (FANV). Objetivos Descrever os primeiros resultados de uma experiência inicial multicêntrica no Brasil e investigar a viabilidade, a segurança e a eficácia da oclusão do AAE com o novo dispositivo LAmbre. Métodos Coletamos dados do procedimento e do acompanhamento de 51 pacientes consecutivos com FANV, restrições para ACO em longo prazo e com anatomia adequada, submetidos à oclusão do AAE com o dispositivo LAmbre em 18 centros no Brasil. Indicações para o procedimento foram: sangramento importante em pacientes recebendo ACO (47,1%), AVC ou trombo persistente no AAE apesar de ACO adequada (27.5%), sangramento e AVC (17.6%), outras contraindicações clínicas apara ACO (5,9%), e escolha do paciente devido à prática esportiva (1,9%). Resultados Foram estudados 25 homens (49%) e 26 mulheres (51%), com idade média de 76±7,7 anos, escore CHA2DS2-VASc médio de 4,6± 1,7 e escore HAS-BLED médio de 3.4± 1,1. A taxa de sucesso do procedimento foi de 100%. As complicações imediatas relacionadas ao procedimento foram derrame pericárdico em dois pacientes, e embolização do dispositivo em um caso. Não foram observados shunts residuais > 5mm. Shunts < 5mm foram detectados em quatro pacientes por Doppler colorido ao final do procedimento. Após um período médio de acompanhamento de 18 meses ± 12 meses, não foram observados óbito, AVC ou complicações maiores. Conclusão A oclusão do AAE com o dispositivo LAmbre foi segura e eficaz nesta pequena série de casos. Apesar desses resultados iniciais encorajadores, dado o pequeno número de casos, serão necessários mais estudos com um maior período de acompanhamento.

show abstract

Section: Discussionunclassified

Oclusão do Apêndice Atrial Esquerdo com a Prótese Lambre: Experiência Multicêntrica Inicial no Brasil

Chamié¹,

Guérios²,

Peralta³

et al. 2022

Arquivos Brasileiros De Cardiologia

View full text Add to dashboard Cite

show abstract

“…LAA closure with the LAmbre device showed encouraging results in previous studies [ 15 , 18 – 20 ]. Surprisingly, the small-umbrella LAmbre device was underused in those studies, and there are only a couple of case reports showing its effectiveness [ 21 – 23 ]. In this study, we aimed to evaluate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for occlusion of morphologically complicated LAA in patients with NVAF.…”

Section: Introductionmentioning

confidence: 99%

Occluding morphologically complicated left atrial appendage using the small-umbrella LAmbre device

Zhang

Yang

Xing

et al. 2022

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background Percutaneous left atrial appendage (LAA) occlusion is effective for stroke prevention in patients with atrial fibrillation. LAA can have a complex anatomy, such as multiple lobes or a large orifice, which may render it unsuitable for occlusion using regular devices. We aimed to investigate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for morphologically complicated LAA. Methods We retrospectively enrolled 129 consecutive patients who underwent LAA occlusion using the LAmbre device; the small-umbrella LAmbre device was used in 30 of these patients. We analyzed patients’ characteristics, procedural details, and outcomes. Results Twenty-two patients (73.3%) had multilobed (≥ 2) LAA. The umbrella of the occluder was anchored in the branch in 9 patients and in the common trunks of branches in 13 patients. The landing zone and orifice diameters were 19.0 ± 4.39 mm and 27.4 ± 3.95 mm, respectively. The sizes of the umbrella and occluder cover were 22.0 ± 3.42 mm and 34.3 ± 2.75 mm, respectively. At 3-month follow-up transesophageal echocardiography in 24 patients, no peri-device residual flow was reported. Device thrombosis was detected in one patient at 3 months and disappeared after 3 months of anticoagulation. Ischemic stroke occurred in one patient; no other adverse events were reported. Conclusions Occlusion of morphologically complicated LAA using the small-umbrella LAmbre device was feasible, safe, and effective in patients with atrial fibrillation in this study. This occluder provides an alternative for patients who cannot be treated with regular-sized LAA occlusion devices.

show abstract

“…The LAmbre TM occluder was recently introduced to clinical practice and small registry studies have shown high success rates for implantation and acceptable periprocedural complication rates 10‐12 . Data of a combined procedure with the LAmbre device are still lacking.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9] The LAmbre TM occluder was recently introduced to clinical practice and small registry studies have shown high success rates for implantation and acceptable periprocedural complication rates. [10][11][12] Data of a combined procedure with the LAmbre device are still lacking. Different from Amplatzer devices, the umbrella of the LAmbre device has a double stabilization design with eight small distal hooks that engage into the wall of the left atrial appendage (LAA) and eight U-shaped ends trapping in LAA trabeculations (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Delayed pericardial effusion after left atrial appendage closure with the LAmbre device: Importance of a fully open umbrella

Xiao

Chen

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction We aimed to investigate whether a modified implantation method facilitating a fully open umbrella can reduce the pericardial effusion/pericardial tamponade (PE/PT) rate after left atrial appendage closure (LAAC) with the LAmbre device compared with the conventional method (CM) in patients with non‐valvular atrial fibrillation (NVAF). Methods and Results Patients with NVAF who received either isolated LAAC or combined catheter ablation and LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were enrolled. CM was used for device implantation in the initial 59 patients, while a modified method (MM) was used in the remaining 165 patients. Successful implantation was achieved in 98.3% of patients in the CM group and 98.8% in the MM group. A higher rate of a fully open umbrella (98.8% vs. 69%, p < .001), less requirement for recapture (46% vs. 62.1%, p = .036), and a lower incidence of delayed PE/PT (1.2% vs. 8.6%, p = .005) were found in the MM group compared with the CM group. All of the five delayed PT events occurred in patients with combined treatment. An umbrella that was not fully open was the only factor associated with delayed PE/PT events in a multivariable Cox model. Conclusions LAAC with the LAmbre device using an MM significantly increases the rate of a fully open umbrella and decreases the requirement for recapture and the incidence of delayed PE/PT. This method is more effective in patients with combined treatment.

show abstract

Late clinical outcomes of lambre versus amplatzer occluders for left atrial appendage closure

Cited by 16 publications

References 32 publications

Oclusão do Apêndice Atrial Esquerdo com a Prótese Lambre: Experiência Multicêntrica Inicial no Brasil

Oclusão do Apêndice Atrial Esquerdo com a Prótese Lambre: Experiência Multicêntrica Inicial no Brasil

Occluding morphologically complicated left atrial appendage using the small-umbrella LAmbre device

Delayed pericardial effusion after left atrial appendage closure with the LAmbre device: Importance of a fully open umbrella

Contact Info

Product

Resources

About