“…The LARIAT procedure for percutaneous LAA closure requires both endocardial and epicardial access. The LARIAT Suture Delivery Device is guided over the LAA in an over‐the‐wire approach to slip a prettied suture loop over the appendage under transesophageal echocardiographic guidance to achieve appendage closure …”
LAA closure using ACP is a relatively feasible procedure which can be performed by highly experienced operators to reduce stroke rate in patients with AF, high stroke risk, and contraindication to oral anticoagulants.
“…The LARIAT procedure for percutaneous LAA closure requires both endocardial and epicardial access. The LARIAT Suture Delivery Device is guided over the LAA in an over‐the‐wire approach to slip a prettied suture loop over the appendage under transesophageal echocardiographic guidance to achieve appendage closure …”
LAA closure using ACP is a relatively feasible procedure which can be performed by highly experienced operators to reduce stroke rate in patients with AF, high stroke risk, and contraindication to oral anticoagulants.
“…A new percutaneous closure device (LARIAT ™ snare device; SentreHeart, Inc, Palo Alto, California), has been evaluated recently in animals and used clinically in patients . In an observational, single center study, 81 of 85 patients had complete closure and there were no complications due to the device.…”
These results show that percutaneous LAA exclusion can be achieved successfully with an acceptable rate of periprocedural and short-term complications. Further studies and longer follow-up are needed to determine whether LAA exclusion lowers the long-term risk of thromboembolic events in patients with AF and contraindications to anticoagulation.
“…Histological examination of LAA in animals undergoing ligation with Lariat device have demonstrated complete endothelialization within 7 days on the endocardial surface, with no evidence of inflammation or necrosis and complete atrophy of the LAA at 1‐month duration . These observations are probably related to obstruction of epicardial blood flow with the Lariat suture results in complete ischemic necrosis of the distal LAA resulting in atrophy.…”
Despite incomplete LAA ligation by Lariat device there is significant anatomical and electrical remodeling that resulted in reduction in LAA size, volume, and electrical activity.
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