Usable implantation depth for watchman left atrial appendage occlusion is greater with appendage angiography than transesophageal echocardiography

Glassy, Matthew S.; Sharma, Gaurav; Singh, Gagan D.; Smith, Thomas W.; Ding, Fan; Rogers, Jason H.

doi:10.1002/ccd.27916

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Before the procedure, transesophageal echocardiography (TEE) was used to confirm the absence of a thrombus in the LAA or LA. Baseline measurements of the depth and thickness of the ridge and LAA ostial diameter were obtained at standard 0, 45, 90, and 135 TEE views of the omniplane as described in a previous study ( 15 ). Besides the lobe number, we also characterized the LAA shape through TEE evaluation as either windsock, chicken wing, cactus, cauliflower, or mixed, as described earlier ( 16 , 17 ).…”

Section: Methodsmentioning

confidence: 99%

Catheter ablation in combined procedures is associated with residual leaks

Zhu

Chu

et al. 2023

Front. Cardiovasc. Med.

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ObjectivesTo compare patients with atrial fibrillation (AF) undergoing left atrial appendage closure (LAAC) with catheter ablation (CA) and those without CA.BackgroundThe CA of AF may cause ridge edema, which may affect the safety of LAAC.MethodsPatients with AF (N = 98) who underwent LAAC (combined CA + LAAC procedure group; N = 51) or alone (LAAC group; N = 47) received pre-procedural, intra-procedural, and 6 week post-procedural transesophageal echocardiography (TEE). The depth and ostial diameter of LAA, device compression, residual leak, and ridge thickness were evaluated in the patients who had undergone combined and alone procedures, as well as images of LAA and primary clinical characteristics.ResultsA residual leak was identified in 27 patients at 6 weeks after implantation by TEE (19 in the combined procedures group and eight in the alone group; p = 0.04). The combined procedure group had a significantly higher rate of a new residual leak than the alone group (25.5 vs. 8.5%; p = 0.03). Meanwhile, compared with at the time of implant, a smaller amount of device compression ratio was significant after 6 weeks (22.44 ± 3.90 vs. 19.59 ± 5.39; p = 0.03). There was no significant difference between both groups in all-cause mortality, cardiovascular mortality, and TIA/stroke/system embolism.ConclusionThe combined procedures of CA and LAAC for AF are feasible and safe; however, during the follow-up period, we found that the resolution of ridge edema caused by CA might cause an increased residual leak and a smaller device compression ratio.

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Section: Methodsmentioning

confidence: 99%

Catheter ablation in combined procedures is associated with residual leaks

Zhu

Chu

et al. 2023

Front. Cardiovasc. Med.

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“…К ним относится предоставление дополнительной информации о глубине УЛП, что может быть особенно ценно, когда по измерениям с помощью ЧпЭхоКГ пациенты не имеют достаточной глубины для установки окклюзирующего устройства. КТ-ангиография имеет более высокую чувствительность в оценке остаточного потока, а также отличается неинвазивностью [10,[28][29][30].…”

Section: принятые сокращенияunclassified

Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation

Galyautdinov

Ibragimova²,

Galeeva

2023

Kazan Med J

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Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 20132022 was used.

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“…Although the device requires an LAA ostial diameter of at least 14 mm, we decided to perform the procedure anyway because of the possibility that there was an underestimation of the ostial diameter by TOE and CT, and the safe distal device advancement and strong radial force of WATCHMAN FLX. 1 , 2 …”

mentioning

confidence: 99%

WATCHMAN FLX implantation with an extremely small left atrial appendage ostium

Yano

Egami

Nishino

et al. 2022

European Heart Journal - Case Reports

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An 84-year-old man with paroxysmal AF underwent a left atrial appendage (LAA) occlusion using a WATCHMAN FLX. Pre-procedural transesophageal echocardiography (TEE) revealed a very small LAA ostium and depth ([11.3 mm ostium × 10.8 mm depth [45°], 10.0 mm ostium ×11.9 mm depth [90°] and 11.9 mm ostium × 11.9 mm depth [135°], respectively]. The WATCHMAN FLX (20 mm) was deployed, and the post-release diameter ranged from 17.0-18.2 mm (9-15% compression) and TEE revealed a well-seated device. A sufficient LAA seal was confirmed by TEE 45-days after the WATCHMAN FLX implantation.

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Usable implantation depth for watchman left atrial appendage occlusion is greater with appendage angiography than transesophageal echocardiography

Cited by 4 publications

References 16 publications

Catheter ablation in combined procedures is associated with residual leaks

Catheter ablation in combined procedures is associated with residual leaks

Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation

WATCHMAN FLX implantation with an extremely small left atrial appendage ostium

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Usable implantation depth for watchman left atrial appendage occlusion is greater with appendage angiography than transesophageal echocardiography

Cited by 4 publications

References 16 publications

Catheter ablation in combined procedures is associated with residual leaks

Catheter ablation in combined procedures is associated with residual leaks

Possibilities of computed and magnetic resonance imaging of the heart in patients with ­atrial fibrillation

WATCHMAN FLX implantation with an extremely small left atrial appendage ostium

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Possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation