Intraprocedural and Long‐Term Incomplete Occlusion of the Left Atrial Appendage Following Placement of the WATCHMAN Device: A Single Center Experience

Bai, Rong; Horton, Rodney; Biase, Luigi Di; Mohanty, Prasant; Pump, Agnes; Cardinal, Deb; Scallon, Chantel; Mohanty, Sanghamitra; Santangeli, Pasquale; Brantes, Mauricio Cereceda; Sánchez, Javier; Burkhardt, J. David; Zagrodzky, Jason; Gallinghouse, G. Joseph; Natale, Andrea

doi:10.1111/j.1540-8167.2011.02216.x

Cited by 84 publications

(58 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, earlier occurrence of device decompression, prior to complete endotheliazation, may lead to device dislocation and may cause peridevice leaks. This may explain the observation by Freixa et al [15] that a lower degree of ACP compression was linked to the occurrence of late peridevice leaks. In several implantation series with Plaato™, Watchman™ and Amplatzer™ devices, there was no association between the presence of residual peri-device flow and the occurrence of thromboembolic events [1,2,13,14].…”

Section: Discussionsupporting

confidence: 50%

“…Incomplete LAA closures after implantation of a percutaneous closure device are reported for all devices [1][2][3][4][5][13][14][15]. Sick and coworkers reported a 7% early peri-device flow in 75 Watchman™ patients [1].…”

Section: Discussionmentioning

confidence: 99%

“…The investigators revealed a rate of any peri-device flow after Watchman™ implantation of 41% to 32%, after 1 month and 1 year; respectively [5]. Bai et al [15] found an incidence of peri-device leaks in up to 35% in a series of 58 consecutive patients 1 year after Watchman™ implantation. In this study, the leaks were more likely to become bigger and also new gaps occurred.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Left atrial appendage closure with the Amplatzer™ Cardiac Plug: Rationale for a higher degree of device oversizing at implantation

Neuzner

Dietze²,

Paliege³

et al. 2015

Cardiol J

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left atrial appendage closure with the Amplatzer™ Cardiac Plug: Rationale for a higher degree of device oversizing at implantation

Neuzner

Dietze²,

Paliege³

et al. 2015

Cardiol J

View full text Add to dashboard Cite

show abstract

“…Similar to the surgical experience, manifestation of incomplete LAA occlusion following various types of endocardial and epicardial percutaneous LAA closure has been well-described (16)(17)(18)(19)(20). As with surgical techniques, there is limited data available on the long-term prognosis of incomplete percutaneous LAA closure.…”

Section: Other Implicationsmentioning

confidence: 90%

Incomplete surgical ligation of the left atrial appendage—time for a new look at an old problem

Aryana¹,

Bhaskar²

2017

Ann. Transl. Med.

View full text Add to dashboard Cite

“…26 Other studies have replicated this experience. 27 The cardioembolic significance of this remains unclear, as the event rate was exceedingly low in the PROTECT AF study population.…”

Section: Data In Patients With Contraindications To Anticoagulationmentioning

confidence: 99%

Left Atrial Appendage Closure Devices For Stroke Prevention

Kapur¹,

Mansour²

2011

Arrhythmia &Amp; Electrophysiology Review

View full text Add to dashboard Cite

Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting more than three million Americans. 1 The management of AF revolves around the alleviation of symptoms related to an accelerated and irregular ventricular response, and the prevention of cardioembolism, notably stroke. In patients with AF, there is a fivefold increased incidence of embolic stroke. 2 The prevention of systemic embolism has seen significant progression with the recent development of novel oral anticoagulants. However, these medications are associated with poor compliance leaving many patients with AF without systemic anticoagulation. A recent meta-analysis highlighted the current issues with pharmacological prophylaxis in AF.3 Of the 29,272 participants who received warfarin as part of a randomised, phase III trial, the median time in therapeutic ranged from 58 % to 68 %. The event of stroke or systemic embolisation with all-comers on warfarin occurred in 1,107 out of 29,229 patients or 3.8 %. Even with all novel oral anticoagulants, this outcome occurred in 911 out of 29,312 patients or 3.1 %. Even more concerning, major bleeding occurred in 1,541 and 1,802 patients on novel anticoagulants and warfarin, respectively.These are discouraging data, as the devastating side effect of major bleeding outpaces the outcome (stroke or systemic embolisation) we are primarily trying to prevent. Ideally, prophylaxis would effectively limit the embolisation risk without the glaring side effect of bleeding complications. It is for this reason that non-pharmacological prevention of embolism has garnered interest. Among patients with non-valvular AF, the majority of thrombi are located within the left atrial appendage (LAA). As such, non-pharmacological therapy has centred on occlusion, obliteration or removal of the LAA. The Left Atrial AppendageThe LAA empties into the left atrium through an orifice located between the left upper pulmonary vein and the left ventricle. 4 Its unique anatomy, often multilobulated and trabeculated, allows predisposition to in situ thrombus formation. Studies using various imaging modalities demonstrate significant heterogeneity in LAA morphology, 5-7 which complicates mechanical occlusion of the appendage. The physiological role of the LAA is incompletely understood, but is likely important in natriuresis and volume regulation.8 However, pathophysiological descriptions of the LAA, is a source of embolism in AF, are well described and date back to the 1940s. 9 Review of human data has suggested that at least 90 % of left atrial thrombi are found within the LAA. 10 As such, the concept of LAA modification as a method to reduce thromboembolism has arisen. A variety of surgical techniques have been described to close the LAA, with various degrees of efficacy.11 In the 1990s, interest was increased with the inclusion of atrial appendage removal at the time of Maze procedure.12 A retrospective study of 205 patients who underwent mitral valve replacement, analysed a group of 58 patients in which LAA ligation was perfo...

show abstract

Intraprocedural and Long‐Term Incomplete Occlusion of the Left Atrial Appendage Following Placement of the WATCHMAN Device: A Single Center Experience

Cited by 84 publications

References 17 publications

Left atrial appendage closure with the Amplatzer™ Cardiac Plug: Rationale for a higher degree of device oversizing at implantation

Left atrial appendage closure with the Amplatzer™ Cardiac Plug: Rationale for a higher degree of device oversizing at implantation

Incomplete surgical ligation of the left atrial appendage—time for a new look at an old problem

Left Atrial Appendage Closure Devices For Stroke Prevention

Contact Info

Product

Resources

About