Left Atrial Appendage Occlusion in the Presence of Thrombus With a LAmbre Device

Cruz-González, Ignacio; Barahona, Monica Fuertes; Moreno-Samos, José Carlos; Barreiro-Pérez, Manuel; Rodríguez-Collado, Javier; González-Calle, David; Sánchez, Pedro L.

doi:10.1016/j.jcin.2017.05.036

Cited by 8 publications

(9 citation statements)

References 2 publications

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“…The dislodged LAAC device was retrieved by a percutaneous approach [24]. A further particular case reported a successful deployment of a LAmbre™ LAAC in a patient with documented thrombus in the LAA [23]. In this exceptional case, the patient presented with cerebral stroke after having discontinued OAC with direct inhibitor of factor Xa in the setting of a dental procedure.…”

Section: Resultsmentioning

confidence: 99%

“…A further multicenter observational feasibility and safety study reported 100% success rate without any periprocedural complications (0%) in n = 20 patients treated with the LAmbre™ LAAC using the FuStar [17]. In some publications, which were partly excluded from the systematic analysis, the favorable implantion properties of the LAmbre™ for difficult anatomies such as shallow or multilobular LAA anatomies, or in cases with LAA thrombus resistant to OAC, were described [11,23]. The remaining retrieved case reports referred to experiences of LAmbre™ LAAC procedures with particular LAA anatomies.…”

Section: Resultsmentioning

confidence: 99%

“…In this exceptional case, the patient presented with cerebral stroke after having discontinued OAC with direct inhibitor of factor Xa in the setting of a dental procedure. The chicken wing shaped LAA revealed a thrombus, and after discussion it was decided to conduct LAA occlusion using a LAmbre™ device, which was successful and without further cerebral embolism [23].…”

Section: Resultsmentioning

confidence: 99%

“…The first case of LAAC with the Conformité Européenne (CE) mark-obtaining LAmbre™ device in the presence of Table 4 Pre-and thrombus was reported in 2017. The characteristic composition of this 2-part-device could make this device ideal for LAAC with a thrombus present if the LAA, since it might potentially prevent thrombus migration [23]. For this particular condition, however, we need more data to confirm this specific indication.…”

Section: Discussionmentioning

confidence: 98%

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Systematic review on left atrial appendage closure with the LAmbre device in patients with non-valvular atrial fibrillation

Ali

Rigopoulos

Mammadov

et al. 2020

BMC Cardiovasc Disord

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Background: Percutaneous closure (LAAC) of the left atrial appendage (LAA) is an efficacious preventive procedure for patients with non-valvular atrial fibrillation (NVAF) and considerable bleeding risk. We sought to systematically review the available LAAC data on the novel occluder device LAmbre™. Methods: For this systematic review, a search of the literature was conducted by 3 independent reviewers, reporting the safety and therapeutic success of LAAC in patients being treated with a LAmbre™. Publications reporting the safety and therapeutic success of LAAC using LAmbre™ in n > 5 patients were included. Results: The literature search retrieved n = 10 publications, encompassing n = 403 NVAF patients treated with a LAmbre™ LAAC, with relevant data regarding safety and therapeutic success of the procedure. The mean CHA 2 DS 2-VASc Score was 4.0 + 0.9, and the mean HAS-BLED score was 3.4 + 0.5. The implantation success was 99.7%, with a mean procedure time of 45.4 ± 18.7 min, and a fluoroscopy time of 9.6 ± 5.9 min, and a contrast agent volume of 96.7 ± 0.7 ml. The anticoagulation regimen was switched to DAPT post procedure in the majority of the patients (96.8%). Partial and full recapture were done in 45.5% and in 25.6%, respectively. Major complications were reported in 2.9%, with 0.3% mortality, 1.7% pericardial tamponade, 0.3% stroke, and 0.6% major bleeding complications; no device embolization was observed. During follow up at 6 or 12 months, major adverse cardiovascular events were reported in 3.3%: Stroke or TIA in 1.7%, thrombus formation on the device in 0.7%, and residual flow > 5 mm in 1.0%. In some publications, the favorable implantion properties of the LAmbre™ for difficult anatomies such as shallow or multilobular LAA anatomies were described. Conclusions: This systematic review on the LAmbre™ LAA-occluder including n = 403 NVAF patients demonstrates an excellent implantion success rate, promising follow-up clinical data, and favorable properties for also challenging LAA anatomies,. While its design seems to be helpful in preventing device embolization, pericardial tamponade may not be substantially reduced by the LAmbre™ as compared with other established LAAC devices. Further larger prospective multicenter registries and randomized trials are needed to scrutinize the value of the LAmbre™ compared with established LAAC devices.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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Systematic review on left atrial appendage closure with the LAmbre device in patients with non-valvular atrial fibrillation

Ali

Rigopoulos

Mammadov

et al. 2020

BMC Cardiovasc Disord

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“…Ainda a possibilidade do implante proximal no AAE com pequeno número de manobras para reposicionamento, ajuda a prevenir a perfuração do AAE e possibilita o uso do dispositivo para tratamento dos AAEs com trombo distal por técnica "no-touch", na qual o oclusor é implantado sem avançar a bainha de entrega ou o fio-guia no apêndice. [12][13][14][15] O design dos dispositivos LAmbre (tanto o padrão como o especial) torna-o mais adequado em casos anatômicos particulares, principalmente na existência de zonas de implante (landing zones) rasas ou um desajuste entre um grande óstio e uma zona de implante estreita 16,17 (Figuras 5 e 6).…”

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

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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.

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