Death from pulmonary artery erosion complicating implantation of percutaneous left atrial appendage occlusion device

Sepahpour, Ali; Ng, M.; Storey, Philip; McGuire, Mark A.

doi:10.1016/j.hrthm.2013.07.046

Cited by 40 publications

(15 citation statements)

References 4 publications

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“…Device compression and shape in relation to surrounding vessels is of importance for optimal device and hemodynamic stability over time in order to prevent relevant dislodgment or obstruction of neighboring structures as being recommended by the manufacturer [ 29 ]. It was shown recently, that compression and shape of LAA occlusion devices are changing temporarily within three months after implantation, however its clinical relevance besides complete LAA closure is still under debate [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

- LAA Occluder View for post-implantation Evaluation (LOVE) - standardized imaging proposal evaluating implanted left atrial appendage occlusion devices by cardiac computed tomography

et al. 2016

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BackgroundA standardized imaging proposal evaluating implanted left atrial appendage (LAA) occlusion devices by cardiac computed tomography angiography (cCTA) has never been investigated.MethodscCTA datasets were acquired on a 3rd generation dual-source CT system and reconstructed with a slice thickness of 0.5 mm. An interdisciplinary evaluation was performed by two interventional cardiologists and one radiologist on a 3D multi-planar workstation. A standardized multi-planar reconstruction algorithm was developed in order to assess relevant clinical aspects of implanted LAA occlusion devices being outlined within a pictorial essay.ResultsThe following clinical aspects of implanted LAA occlusion devices were evaluated within the most appropriate cCTA multi-planar reconstruction: (1) topography to neighboring structures, (2) peri-device leaks, (3) coverage of LAA lobes, (4) indirect signs of neo-endothelialization. These are illustrated within concise CT imaging examples emphasizing the potential value of the proposed cCTA imaging algorithm: Starting from anatomical cCTA planes and stepwise angulation planes perpendicular to the base of the LAA devices generates an optimal LAA Occluder View for post-implantation Evaluation (LOVE). Aligned true axial, sagittal and coronal LOVE planes offer a standardized and detailed evaluation of LAA occlusion devices after percutaneous implantation.ConclusionsThis pictorial essay presents a standardized imaging proposal by cCTA using multi-planar reconstructions that enables systematical follow-up and comparison of patients after LAA occlusion device implantation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12880-016-0127-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

- LAA Occluder View for post-implantation Evaluation (LOVE) - standardized imaging proposal evaluating implanted left atrial appendage occlusion devices by cardiac computed tomography

et al. 2016

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“…Delayed cardiac erosion and perforation are possibilities over time and have been described. 55 Finally, the clinical significance of leaks after LAA occlusion, no matter the approach, must be established. The most efficient way of doing so is likely via a registry, given the rate of LAA occlusion therapy, the rate of leaks, and the incidence of thromboembolic events after such therapy.…”

Section: Summary/consensus Statement With Future Directionsmentioning

confidence: 99%

Left Atrial Appendage Occlusion Debate Revisited

2015

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“… *Cardiac perforation: pericardial effusion resulting in surgical intervention/repair—due to transseptal puncture, or LAA closure device which can perforate the LAA±pulmonary artery (acute or after >7 days). 73 74 †Pericardial effusion with tamponade: pericardial effusion resulting in percutaneous treatment/drainage or pericardial window. LAA, left atrial appendage; TIA, transient ischemic attack; AV, arteriovenous.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation: an update

et al. 2014

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. One of its most devastating complications is the development of thromboembolism leading to fatal or disabling stroke. Oral anticoagulation (OAC, warfarin) is the standard treatment for stroke prevention in patients with AF with an increased stroke risk. However, there are several obstacles to long-term OAC therapy, including the risk of serious bleeding, several drug–drug interactions and the need for frequent blood testing. Although newer oral anticoagulants have been developed, these drugs also face issues of major bleeding and non-compliance. Therefore, alternative treatment options for stroke prevention in patients with AF with a high stroke risk are needed. Percutaneous left atrial appendage (LAA) occlusion is an evolving therapy, which should be taken into consideration in those patients with non-valvular AF with a high stroke risk and contraindications for OAC. This article aims to discuss the rationale for LAA closure, the available LAA occlusion devices and their clinical evidence until now. Moreover, we discuss the importance of proper patient selection, the role of various imaging techniques and the need for a more tailored postprocedural antithrombotic therapy.

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Death from pulmonary artery erosion complicating implantation of percutaneous left atrial appendage occlusion device

Cited by 40 publications

References 4 publications

- LAA Occluder View for post-implantation Evaluation (LOVE) - standardized imaging proposal evaluating implanted left atrial appendage occlusion devices by cardiac computed tomography

- LAA Occluder View for post-implantation Evaluation (LOVE) - standardized imaging proposal evaluating implanted left atrial appendage occlusion devices by cardiac computed tomography

Left Atrial Appendage Occlusion Debate Revisited

Percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation: an update

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