Occlusion of an Extremely Large Left Atrial Appendage Using the “Double-LAmbre Technique”

So, Chak-Yu; Leung, Kwok-fai; Lam, Yat‐Yin; Yan, Bryan P.

doi:10.1016/j.jcin.2018.10.015

Cited by 7 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…">Large ostial dimensions often with an associated smaller landing zone; 25 Two lobes separated by a thick muscular crest (managed with a double device closure technique) 25,33 …”

Section: Discussionmentioning

confidence: 99%

“…Two lobes separated by a thick muscular crest (managed with a double device closure technique) 25,33 …”

Section: Discussionmentioning

confidence: 99%

“…Two lobes separated by a thick muscular crest (managed with a double device closure technique). 25,33 Aside from its application in cases of complex LAA anatomy, 3DP could play a role in procedural training. It has been shown…”

Section: Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of the use of 3D printing in left atrial appendage occlusion procedures

Tarabanis

Klapholz

Zahid

et al. 2022

Cardiovasc electrophysiol

View full text Add to dashboard Cite

The placement of a left atrial appendage occlusion (LAAO) device can be a technically challenging transcatheter‐based procedure. Key challenges include accurate pre‐procedural device sizing and proper device positioning at the LAA ostium to ensure sufficient device anchoring and avoid peri‐device leaks. To address these challenges, 3D printing (3DP) of LAA models has recently emerged in the literature, first being described in 2015. We present a review of the benefits and drawbacks of employing this technology for LAAO procedures. Pre‐procedurally the use of 3DP can consistently and accurately determine LAAO device size over standard of care approaches. Intra‐procedurally 3DP's impact entailed a statistically significant decrease in the number of devices used per procedure, as well as in the fluoroscopic time and dose. Post‐procedurally, there is some evidence that 3DP could reduce the rate of peri‐device leaks, with limited data on its effect on complication rates. Based on existing evidence, we recommend the focused application of 3DP to cases of complex LAA anatomy and for the training of proceduralists. Lastly, we address the emergence of next generation LAAO devices and AR/VR systems that could limit even this narrow window of clinical benefit afforded by 3DP.

show abstract

“…">Large ostial dimensions often with an associated smaller landing zone; 25 Two lobes separated by a thick muscular crest (managed with a double device closure technique) 25,33 …”

Section: Discussionmentioning

confidence: 99%

“…Two lobes separated by a thick muscular crest (managed with a double device closure technique) 25,33 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of the use of 3D printing in left atrial appendage occlusion procedures

Tarabanis

Klapholz

Zahid

et al. 2022

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…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

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

“…For more complex anatomies that are not compatible with any of the available devices, there are descriptions that prove the feasibility of the off-label implant of a double occluder device, using two dedicated devices or one dedicated device associated with another non-dedicated device. [41][42][43] Such interventions, however, should be considered as an exception, knowing that there is neither enough experience nor follow-up to determine their validity.…”

Section: Journal Of Transcatheter Interventionsmentioning

confidence: 99%

Percutaneous occlusion of the left atrial appendage: the state-of-the-art

Guérios¹,

Chamié²

2019

J Transcat Intervent

View full text Add to dashboard Cite

Stroke is the complication of atrial fibrillation with the greatest social and economic impact. The prevalence of this arrhythmia is epidemically growing. Although oral anticoagulants are highly effective, their contraindications, hemorrhagic complications and non-compliance of patients result in underutilization of this therapy. This review addresses aspects related to endocardial occlusion of the left atrial appendage as an alternative strategy to antithrombotic therapy, ranging from the introduction of the technique in clinical practice, the new devices being developed, technical peculiarities, and economic aspects, to uncertainties related to the intervention.

show abstract

Occlusion of an Extremely Large Left Atrial Appendage Using the “Double-LAmbre Technique”

Cited by 7 publications

References 3 publications

A systematic review of the use of 3D printing in left atrial appendage occlusion procedures

A systematic review of the use of 3D printing in left atrial appendage occlusion procedures

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

Percutaneous occlusion of the left atrial appendage: the state-of-the-art

Contact Info

Product

Resources

About