Left Atrial Appendage Occlusion Guided Only by Transesophageal Echocardiography

Zhao, Jinlong; Li, Feng; Zhang, Yueli; Zhuang, Zhongyun; Wang, Man; Fu, Liang; Ni, Yingmeng; Lu, Zhexin; Chen, Zonghui; Zhang, Cheng

doi:10.1155/2019/1376515

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…[ 29 ] Incomplete blockade (shunt >5 mm) can still lead to cardiogenic thrombosis, and oral anticoagulation will still be a daily task for these patients. [ 30 ] To address these issues, some scholars have proposed Three/3 Dimensions modeling of the LAA opening and then Three/3 Dimensions printing to guide LAAO, [ 31 ] while some scholars [ 32 ] have proposed multi-angle and multi-dimensional occlusion guidance to achieve the best fit of the occluder disk to the LAA opening. However, we believe that, in addition to the above methods, upgrading the blocking device, customizing the blocker according to the anatomical structure of the patient’s LAA and the opening, or adopting an umbrella-type structure for the external disk to cover as wide a range of LAA openings as possible may be a direction or trend for future research.…”

Section: Discussionmentioning

confidence: 99%

The progress of percutaneous left atrial appendage occlusion: A bibliometric analysis from 1994 to 2022

Zhai,

Kang,

et al. 2024

Medicine

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Background: Atrial fibrillation is the most common cardiac arrhythmia, affecting 32 million individuals worldwide. Although atrial fibrillation has been studied for decades, a comprehensive analysis using bibliometrics has not been performed for atrial fibrillation-left atrial appendage occlusion (LAAO). Therefore, we analyzed the scientific outputs of global LAAO research and explored the current research status and hotpots from 1994 to 2022. Methods: We searched the Web of Science core collection for publications related to LAAO that were published between 1994 and 2022. We then performed bibliometric analysis and visualization using Microsoft Excel 2021, Bibliometric (https://bibliometric.com), VOSviewer (version 1.6.19), CiteSpace (version 6.2. R2), and the Bibliometrix 4.0.0 Package (https://www.bibliometrix.org) based on the R language were used to perform the bibliometric analysis, trend and emerging foci of LAAO in the past 29 years, including author, country, institution, journal distribution, article citations, and keywords. In total, we identified 1285 eligible publications in the field of LAAO, with an increasing trend in the annual number of publications. Results: The United States is the country with the most published articles in this field, while the United Kingdom is the country with the most cited literature. Mayo Clinic, from the United States, has the most publications in this area and Horst Sievert from Germany had the highest number of individual publications. The analysis of keywords showed that fibrillation, stroke, safety, oral anticoagulants, and watchman were the main hotpots and frontier directions of LAAO. Surgical treatment of nonvalvular atrial fibrillation, upgrading of related surgical instruments, and anticoagulation regimen after surgical treatment are the major research frontiers. Conclusion: We show that the research of percutaneous LAAO has been increasing rapidly over the last decade. Our aim was to overview past studies in the field of LAAO, to grasp the frame of LAAO research, and identify new perspectives for future research.

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Section: Discussionmentioning

confidence: 99%

The progress of percutaneous left atrial appendage occlusion: A bibliometric analysis from 1994 to 2022

Zhai,

Kang,

et al. 2024

Medicine

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“…There are limited data on LAA occlusion guided solely by TEE. A single-center prospective study with 14 patients demonstrated successful and safe implantation of LAmbre (LAA occlusion device; Lifetech Scientific (Shenzhen) Co. Ltd., Shenzhen, China) with TEE only [4].…”

Section: Discussionmentioning

confidence: 99%

Transesophageal Echocardiography-Guided WATCHMAN Implantation Without Contrast Use: A Three-Year, Single-Center Experience

Shaukat

Patel

Alimohammad

et al. 2020

Cureus

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Background It is unclear if the WATCHMAN device (Boston Scientific, St. Paul, Minnesota) can be implanted without contrast to prevent complications in patients with advanced chronic kidney disease (CKD) or contrast allergy. Objective The efficiency and safety of WATCHMAN implantation under transesophageal echocardiography (TEE)-guidance and fluoroscopy without contrast use. Methods This was a retrospective single-center study at Albany Medical Center between June 2016 and June 2019. Consecutive procedure notes for all WATCHMAN devices implanted between June 2016 and June 2019 were screened to identify patients who did not receive contrast. Patients with incomplete information on the calculation of the 'Congestive heart failure, Hypertension, Age [>75 years], Stroke, Diabetes mellitus, Vascular disease, Age [65 to 74 years], Sex category' (CHA2DS2VASc)/'Hypertension, Abnormal renal/liver function, Stroke, Bleeding history, Labile international normalized ratio, Elderly, Drugs/alcohol' (HAS-BLED) score and reason(s) precluding safe contrast use were excluded. Efficiency was measured as i) accuracy of device size estimation based on TEE-measured left atrial appendage (LAA) dimensions were determined by the need to change the size of the device initially selected, ii) number of implantation attempts, irrespective of change in device size, iii) whether more than one device was used secondary to inaccurate initial size estimation or other procedural complexities, and iv) successful LAA seal on TEE immediately and 45-days post-implantation (peri-device leak of < 5 mm by color Doppler). Procedure-related complications, immediate and delayed (0-45 days), were recorded. Results Twelve patients received WATCHMAN without contrast. The mean age was 79.2 years, with male predominance (n=8). The mean CHA2DS2VASc and HAS-BLED scores were 5.50 (+/-1.24) and 4.08 (+/-1.08), respectively. Contrast was avoided because of a history of CKD stage IV (n=5), rapidly progressive CKD stage III (n=1), and contrast allergy (n=6). In 11 out of 12 patients, initial TEE-based device size estimation was accurate with successful implantation at 1 2 3 3

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“…In order to make full use of the advantages of TEE, we have been able to complete percutaneous endocardial LAA occlusion under the guidance of TEE alone, avoiding the radiation of doctors and patients (18). In the cases of thoracoscopic radiofrequency ablation, we also performed percutaneous LAA occlusion guided by TEE.…”

Section: Discussionmentioning

confidence: 99%

Modified epicardial left atrial appendage occulusion during thoracoscopic radiofrequency ablation of atrial fibrillation.

Zhao

Yuan-fu

Zhang

et al. 2020

Preprint

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Aims To investigate a modified method of epicardial left atrial appendage (LAA) occlusion under the guidance of thoracoscopy and transesophageal echocardiography (TEE) during radiofrequency ablation of atrial fibrillation. Methods and Results 19 patients with atrial fibrillation underwent left atrial appendage occlusion and atrial fibrillation radiofrequency ablation in two centers under the guidance of thoracoscopy and TEE. All of the surgeries were completed in a general surgery setting, avoiding fluoroscopy, and in each case the entire procedure was guided by TEE. Radiofrequency ablation of atrial fibrillation was performed by Wolf mini-maze. All operations went smoothly with no serious complications. Postoperative TEE indicated that each device was in a good position and there was no residual shunt around any of the devices. Conclusions It is safe and reliable to apply the left atrial appendage closure device to perform epicardial left atrial appendage occlusion guided only by TEE, which is radiation-free. And it can be performed simultaneously during the thoracoscopic radiofrequency ablation of atrial fibrillation.

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Left Atrial Appendage Occlusion Guided Only by Transesophageal Echocardiography

Cited by 6 publications

References 20 publications

The progress of percutaneous left atrial appendage occlusion: A bibliometric analysis from 1994 to 2022

The progress of percutaneous left atrial appendage occlusion: A bibliometric analysis from 1994 to 2022

Transesophageal Echocardiography-Guided WATCHMAN Implantation Without Contrast Use: A Three-Year, Single-Center Experience

Modified epicardial left atrial appendage occulusion during thoracoscopic radiofrequency ablation of atrial fibrillation.

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