Left atrial appendage occlusion in high-risk patients with non-valvular atrial fibrillation

Berti, Sérgio; Pastormerlo, Luigi Emilio; Rezzaghi, Marco; Trianni, Giuseppe; Paradossi, Umberto; Cerone, Elisa; Ravani, Marcello; Caterina, Alberto Ranieri De; Rizza, Antonio; Palmieri, Cataldo

doi:10.1136/heartjnl-2015-309150

Cited by 32 publications

(22 citation statements)

References 26 publications

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“…With the need for cardiologic techniques such as trans-septal puncture as well as navigation of catheter devices within the LA and LV, the risk of tamponade may grow. There are two large prospective multicenter studies that have analyzed the risk and outcomes of complications during and after Mitra-Clip based on the German Transcatheter Mitral Valve Interventions register [69] and the European AC-CESS-EU registry [70] (Table V [ 60,66,67,[69][70][71][72][73]). The risk of PT was 1.9% and 1.1% respectively, suggesting that transseptal puncture followed by advancement of the 24 Fr guiding sheath is safe [69].…”

Section: Pericardial Tamponade As a Results Of Percutaneous Mitral Valmentioning

confidence: 99%

Pericardial tamponade as a complication of invasive cardiac procedures: a review of the literature

Adamczyk¹,

Wasilewski²,

Niedziela³

et al. 2019

pwki

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Cardiac tamponade (CT) is a rare but often life-threatening complication after invasive cardiac procedures. Some procedures favor CT. Furthermore, the incidence depends on patients' comorbidities, sex and age and operators' skills. In this paper we review studies and meta-analyses concerning the rate of iatrogenic CT. We define the risk factors of CT and show concise characteristics for each invasive cardiac procedure separately. According to our analysis CT occurs especially after procedures requiring transseptal puncture or perioperative anticoagulation. The overall rate of CT after such procedures varies among published studies from 0.089% to 4.8%. For this purpose we searched the PubMed database for clinical studies published up to December 2018. We included only those studies in which a defined minimum of procedures were performed (1000 for atrial fibrillation ablation, 6000 for percutaneous coronary intervention, 900 for permanent heart rhythm devices, 90 for left atrial appendage closure, 300 for transcatheter aortic valve implantation and percutaneous mitral valve repair with the Mitra-Clip system). The search was structured around the key words and variants of these terms. In addition, secondary source documents were identified by manual review of reference lists, review articles and guidelines. The search was limited to humans and adults (18+ years).

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Section: Pericardial Tamponade As a Results Of Percutaneous Mitral Valmentioning

confidence: 99%

Pericardial tamponade as a complication of invasive cardiac procedures: a review of the literature

Adamczyk¹,

Wasilewski²,

Niedziela³

et al. 2019

pwki

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“…Presently, LAA occlusion is a diffused treatment strategy to reduce the migration of thrombi and the associated cardioembolic risk [4,5]. This procedure is particularly challenging due to the LAA morphological and hemodynamics complexity [6].…”

Section: Introductionmentioning

confidence: 99%

Correlation between LAA Morphological Features and Computational Fluid Dynamics Analysis for Non-Valvular Atrial Fibrillation Patients

et al. 2020

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The left atrial appendage (LAA) is a complex cardiovascular structure which can yield to thrombi formation in patients with non-valvular atrial fibrillation (AF). The study of LAA fluid dynamics together with morphological features should be investigated in order to evaluate the possible connection of geometrical and hemodynamics indices with the stroke risk. To reach this goal, we conducted a morphological analysis of four different LAA shapes considering their variation during the cardiac cycle and computational fluid dynamics (CFD) simulations in AF conditions were carried out. The analysis of main geometrical LAA parameters showed a huger ostium and a reduced motility for the cauliflower and cactus shapes, as well as a lower velocity values from the CFD analysis. Such findings are in line with literature and highlight the importance of coupling dynamics imaging data with CFD calculations for providing information not available at clinical level.

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“…They reported a 7.3% rate of procedure-related complications, and a 10% all-cause mortality over a median follow-up of 9 months. In another study of LAA occlusion in high-risk patients by Berti and colleagues,15 77% of patients had previous bleeding and 21.8% had previous intracranial haemorrhage. The all-cause mortality at 30 months was 12%, of which only 2.7% were due to cardiovascular causes.…”

Section: Discussionmentioning

confidence: 91%

Outcome of left atrial appendage occlusion in high-risk patients

Masoud

Bartoletti

Fairbairn

et al. 2017

Heart

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Left atrial appendage occlusion in high-risk patients with non-valvular atrial fibrillation

Abstract: Our data suggest LAA occlusion in high-risk patients with NVAF not suitable for OACs is feasible and associated with low complication rates as well as low rates of stroke and major bleeding at long-term follow-up.

Cited by 32 publications

References 26 publications

Pericardial tamponade as a complication of invasive cardiac procedures: a review of the literature

Pericardial tamponade as a complication of invasive cardiac procedures: a review of the literature

Correlation between LAA Morphological Features and Computational Fluid Dynamics Analysis for Non-Valvular Atrial Fibrillation Patients

Outcome of left atrial appendage occlusion in high-risk patients

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