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<a href="http://doi.org/10.1161/circinterventions.120.009227" target="_blank" rel="noreferrer noopener">http://doi.org/10.1161/circinterventions.120.009227</a>
Pages
CIRCINTERVENTIONS120009227
ISSN
1941-7632 1941-7640
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Update Year & Number
Hospital List
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Title
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Use of a Novel Septal Occluder Device for Left Atrial Appendage Closure in Patients With Postsurgical and Postlariat Leaks or Anatomies Unsuitable for Conventional Percutaneous Occlusion.
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Circulation: Cardiovascular Interventions
Date
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2020
2020-09-18
Subject
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atrial fibrillation; patent foramen ovale; mitral valve; atrial appendage; transoesophageal echocardiography
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Della Rocca DG; Horton RP; Tarantino N; Van Niekerk CJ; Trivedi C; Chen Q; Mohanty S; Anannab A; Murtaza G; Akella K; Gianni C; Bassiouny M; Ahmadian-Tehrani A; Al-Ahmad A; Burkhardt JD; Natale VN; Price M; Gallinghouse GJ; Gibson DN; Lakkireddy D; Di Biase L; Natale A
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BACKGROUND: Interventional therapies aiming at excluding the left atrial appendage (LAA) from systemic circulation have been established as a valid alternative to oral anticoagulation in patients at high thromboembolic risk. However, their efficacy on stroke prophylaxis may be compromised owing to incomplete LAA closure. Additionally, the need for an alternative thromboembolic prevention may remain unmet in patients with contraindications to oral anticoagulation whose appendage anatomy is unsuitable for some conventional devices commercially available. We aimed at evaluating the feasibility of LAA closure with the novel Gore Cardioform Septal Occluder in patients with incomplete appendage ligation or anatomic features which do not meet the manufacturer's requirements for Watchman deployment. METHODS: Twenty-one consecutive patients (mean age: 72±6 years; 85.7% males; CHA(2)DS(2)-VASc: 4.5±1.4; HAS-BLED: 3.6±1.0) were included. Transesophageal echocardiography was performed within 2 months to assess for residual LAA patency. RESULTS: Fourteen patients had incomplete LAA closure following surgical (n=6) or Lariat ligation (n=8). In 7 patients with an appendage anatomy unsuitable for Watchman deployment, the mean maximal landing zone size and LAA depth were 14.4±1.3and 18.6±2.8 mm. Successful Cardioform Septal Occluder deployment was achieved in all patients. No peri-procedural complications were documented.Procedure and fluoroscopy times were 46±13 and 14±5 minutes. Follow-up transesophageal echocardiography after 58±9 days revealed complete LAA closure in all patients. CONCLUSIONS: Transcatheter LAA closure via a Cardioform Septal Occluder device might be a valid alternative in patients with residual leaks following failed appendage ligation or whose LAA anatomy does not meet the minimal anatomic criteria to accommodate a Watchman device.
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<a href="http://doi.org/10.1161/circinterventions.120.009227" target="_blank" rel="noreferrer noopener">10.1161/circinterventions.120.009227</a>
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journalArticle
2020
Ahmadian-Tehrani A
Akella K
Al-Ahmad A
Anannab A
atrial appendage
Atrial fibrillation
Bassiouny M
Burkhardt JD
Chen Q
Circulation: Cardiovascular Interventions
Della Rocca DG
Di Biase L
Gallinghouse GJ
Gianni C
Gibson DN
Horton RP
Hospital List
journalArticle
Lakkireddy D
mitral valve
Mohanty S
Murtaza G
Natale A
Natale VN
patent foramen ovale
Price M
Tarantino N
transoesophageal echocardiography
Trivedi C
Van Niekerk CJ