Epicardial appendage ooze causing pericardial tamponade after left atrial appendage device implantation

Phillips, K.; Smith, Christopher; Butler, M.; Taylor, Anders; Hall, T. A.

doi:10.1016/j.hrcr.2018.04.013

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…To our knowledge, this is the first reported case of spontaneous left atrial appendage rupture during cardiac tamponade following LAA percutaneous device closure (5,6). From a surgical standpoint, the LAA auricle may be caught in the jaws of the aortic cross-clamp, causing iatrogenic injury (7).…”

Section: Discussionmentioning

confidence: 96%

Left Atrial Appendage Rupture Following Intraoperative Hypertensive Crisis

Marzban,

Benharash

2023

Multidiscip Cardio Annal

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Section: Discussionmentioning

confidence: 96%

Left Atrial Appendage Rupture Following Intraoperative Hypertensive Crisis

Marzban,

Benharash

2023

Multidiscip Cardio Annal

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“…This anatomical characteristic may allow for the maximal diameter to remain as an important measurement in LAAO, along with the perimeter-derived diameter. However, the insertion of grossly large devices may lead to malpositioning of the device and post-procedural complications, including device embolization, peri-device leakage, thrombus formation, and cardiac tamponade 18 , 29 . Additionally, in more eccentric cases with EI > 0.2, the maximal diameter showed significant error compared with the perimeter-derived diameter, leading to overestimation of device size.…”

Section: Discussionmentioning

confidence: 99%

Pre-procedural determination of device size in left atrial appendage occlusion using three-dimensional cardiac computed tomography

Cho

Kim

Lee

et al. 2021

Sci Rep

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The complex structure of the left atrial appendage (LAA) brings limitations to the two-dimensional-based LAA occlusion (LAAO) size prediction system using transesophageal echocardiography. The LAA anatomy can be evaluated more precisely using three-dimensional images from cardiac computed tomography (CT); however, there is lack of data regarding which parameter to choose from CT-based images during pre-procedural planning of LAAO. We aimed to assess the accuracy of measurements derived from cardiac CT images for selecting LAAO devices. We retrospectively reviewed 62 patients with Amplatzer Cardiac Plug and Amulet LAAO devices who underwent implantation from 2017 to 2020. The minimal, maximal, average, area-derived, and perimeter-derived diameters of the LAA landing zone were measured using CT-based images. Predicted device sizes using sizing charts were compared with actual successfully implanted device sizes. The mean size of implanted devices was 27.1 ± 3.7 mm. The perimeter-derived diameter predicted device size most accurately (mean error = − 0.8 ± 2.4 mm). All other parameters showed significantly larger error (mean error; minimal diameter = − 4.9 ± 3.3 mm, maximal diameter = 1.0 ± 2.9 mm, average diameter = − 1.6 ± 2.6 mm, area-derived diameter = − 2.0 ± 2.6 mm) than the perimeter-derived diameter (all p for difference < 0.05). The error for other parameters were larger in cases with more eccentrically-shaped landing zones, while the perimeter-derived diameter had minor error regardless of eccentricity. When oversizing was used, all parameters showed significant disagreement. The perimeter-derived diameter on cardiac CT images provided the most accurate estimation of LAAO device size regardless of landing zone eccentricity. Oversizing was unnecessary when using cardiac CT to predict an accurate LAAO size.

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