Incidence and Clinical Impact of Device-Associated Thrombus and Peri-Device Leak Following Left Atrial Appendage Closure With the Amplatzer Cardiac Plug

Abstract

Following successful left atrial appendage closure with the Amplatzer Cardiac Plug, the presence of peri-device leak was relatively low, and device-associated thrombus was infrequent. Neither was associated with increased risk for thromboembolism.

Late clinical outcomes of lambre versus amplatzer occluders for left atrial appendage closure

“…Major peri‐device leaks were not associated with DRT or thromboembolic events during follow‐up. This observation confirms the results of a study with 339 patients using the ACP for LAAC, which found no association of peri‐device leaks and ischemic events 25 . However, the rate of DRT was higher in the LAmbre than in the Amplatzer group, although statistical significance was not reached.…”

“…[14][15][16] The known risk factor for the occurrence of DRT is deep implantation of the device into the neck of the LAA, older age, history of stroke, smoking, and female sex. [25][26][27] In the present study, the rate of all-cause stroke and systemic embolism at follow-up was similar for both devices but slightly higher than reported in other Amplatzer registries (ACP: 2.3%, 6 2.9%:…”

“…This observation confirms the results of a study with 339 patients using the ACP for LAAC, which found no association of peri-device leaks and ischemic events. 25 However, the rate of DRT was higher in the LAmbre than in the Amplatzer group, although statistical significance was not reached. Other LAmbre registries documented lower rates of DRT with 1.3% 12 and 0%.…”

What Lies Beneath Left Atrial Appendage Occlusion

“…This confirms earlier studies. [5][6][7][8][9] It had even been suggested that repositioning a device to decrease the risk of PDL may not be justified because this maneuver may increase the risk for pericardial bleeding. 7 An important lesson of the article is that not only Amplatzer devices but also Watchman devices can be used safely with a post-treatment of only antiplatelet agents.…”

Left Atrial Appendage Closure to Prevent Strokes and Ligation to Prevent Atrial Fibrillation

“…2 A separate study showed a 3.2% DAT rate with the AMPLATZERt Cardiac Plug, a previous generation of the AMPLATZERt Amulett (both Abbott Laboratories, Chicago, IL, USA) currently under investigational device exemption (IDE) trial in the US. 7 While it is certainly not what the implanting physician hopes to see at the 45-day or one-year follow-up on transesophageal echocardiogram (TEE), whether DAT leads to clinical ischemic strokes as a whole has been difficult to determine. Our practice has been to initiate short-term oral anticoagulation and to repeat the TEE in six weeks to ensure resolution, and then return the patient to using antiplatelet therapy alone.…”