Operator Experience and Outcomes after Transcatheter Left Atrial Appendage Occlusion with the Watchman Device

Sawant, Abhishek C.; Seibolt, Luke; Sridhara, Srilekha; Rodriguez, Janelle; Distler, Edward; Murarka, Shishir; Lazkani, Mohamad; Kumar, Arnav; Kanwar, Nidhi; Prakash, Meghana Prakash Hiriyur; Wiesner, Philipp; Pershad, Ashish

doi:10.1016/j.carrev.2019.08.001

Cited by 14 publications

(6 citation statements)

References 20 publications

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“…That said, there have been conflicting data on physician procedural volume in LAAO. 8 Overall, this analysis provides compelling evidence of a clinically relevant relationship between procedural volumes and improved LAAO outcomes. To make this translatable to policy, the authors identified procedural volumes that correspond with 95% procedural success at an institutional and physician level.…”

mentioning

confidence: 79%

Volume-Outcome Relationship in Left Atrial Appendage Occlusion: It Is Not as Simple as It Sounds

Qeska,

Singh,

Wijeysundera

2024

Circ: Cardiovascular Interventions

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mentioning

confidence: 79%

Volume-Outcome Relationship in Left Atrial Appendage Occlusion: It Is Not as Simple as It Sounds

Qeska,

Singh,

Wijeysundera

2024

Circ: Cardiovascular Interventions

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“…Furthermore, structural heart disease interventions require not only enhanced training in technical skills but also thorough training in multimodal imaging in order to gain comprehensive knowledge of cardiac anatomy, particularly for LAAC of the left atrium, LAA, and surrounding structures [ 28 ]. Due to the highly variable and complex LAA anatomy, e.g., the LAAC can be challenging [ 29 ]. Table 6 and Figure 4 present the current advantages of periprocedural fusion imaging guidance in the field of LAAC.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists’ Learning Curve for Percutaneous Left Atrial Appendage Closure—Initial, Single-Center, Retrospective Observations

Kanschik,

Heidari,

Klein

et al. 2024

JCDD

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Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of two interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2). Furthermore, group 1 was compared to 36 procedures of IC 2 who directly started his training with FI (group 3). Group 1 demonstrated that the learning curve without FI has a flat course with weak correlations for fluoroscopy time, contrast volume, and procedure time, but not for dose area product. Group 2 with FI showed improvement with a steep course and strong correlations for all four parameters. In group 3, we also saw a steep progression with strong correlations. Furthermore, the mean measurements of the parameters in the groups with FI decreased significantly as an indicator of procedural efficacy. We demonstrated that FI may improve the learning curve of experienced and non-experienced ICs.

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“…Besides, structural heart disease interventions require not only an enhanced training in technical skills but also a thorough training in multimodal imaging in order to gain comprehensive knowledge of cardiac anatomy, in particularly for LAAC, of the left atrium, LAA, and surrounding structures [29]. Due to the highly variable and complex LAA anatomy e.g., the LAAC can be challenging [30]. Jung et al demonstrated in a large multicenter study involving 83 hospitals and a total of 13651 LAAC procedures that 30 cases are necessary to achieve optimal safety of LAAC [12].…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists´ Learning Curve for Percutaneous Left Atrial Appendage Closure

Kanschik,

Heidari,

Klein

et al. 2023

Preprint

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Due to the complex and variable anatomy of the left atrial appendage, percutaneous left atrial appendage closure (LAAC) can be challenging. In this study, we investigated the impact of fusion imaging (FI) on the LAAC learning curve of 2 interventionalists. The first interventionalist (IC 1) was initially trained without FI and continued his training with FI. The second interventionalist (IC 2) performed all procedures with FI. We compared the first 36 procedures without FI of IC 1 (group 1) with his next 36 interventions with FI (group 2). Furthermore, group 1 was compared to 36 procedures of IC 2 who directly started his training with FI (group 3). Group 1 demonstrated that the learning curve without FI has a flat course with weak correlations for fluoroscopy time, contrast volume, and procedure time, but not for dose area product. Group 2 with FI showed improvement with a steep course and strong correlations for all 4 parameters. In group 3 we also saw a steep progression with strong correlations. Furthermore, the mean measurements of the procedural parameters in the groups with FI decreased significantly as indicator for procedural efficacy. We demonstrated that FI may improve the learning curve of experienced and non-experienced ICs.

show abstract

Operator Experience and Outcomes after Transcatheter Left Atrial Appendage Occlusion with the Watchman Device

Cited by 14 publications

References 20 publications

Volume-Outcome Relationship in Left Atrial Appendage Occlusion: It Is Not as Simple as It Sounds

Volume-Outcome Relationship in Left Atrial Appendage Occlusion: It Is Not as Simple as It Sounds

Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists’ Learning Curve for Percutaneous Left Atrial Appendage Closure—Initial, Single-Center, Retrospective Observations

Echocardiographic-Fluoroscopic Fusion Imaging Improves Interventionalists´ Learning Curve for Percutaneous Left Atrial Appendage Closure

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