Left atrial appendage orifice diameter measured with trans-esophageal echocardiography is independently related with peri-device leakage after Watchman device implantation

Chen, Yu-Yi; Zhang, Yonghua; Chen, Xin; Huang, Weijian; Xu, Biao; Su, Xi; Chen, Yanhong

doi:10.1007/s10554-019-01625-6

Cited by 10 publications

(5 citation statements)

References 27 publications

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“…We found that larger LAA orifice diameter was correlated with the development of PE following LAmbre device implantation. A prior study showed that larger LAA orifice was independently correlated with PDL after Watchman device implantation ( 20 ). We postulate that the occluding devices may be relatively less stable with increasing LAA orifice size.…”

Section: Discussionmentioning

confidence: 99%

Pericardial effusion following percutaneous left atrial appendage closure using the LAmbre device

Chu

Wang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundPericardial effusion (PE) is an uncommon but serious complication that occurs following percutaneous left atrial appendage closure (LAAC). There are few data regarding PE following implantation of the LAmbre device for LAAC.MethodsPatients with nonvalvular atrial fibrillation (AF) undergoing percutaneous LAAC using the LAmbre device at the Arrhythmia Center of Ningbo First Hospital from October 2017 to March 2021 were retrospectively reviewed (n = 133). PE was defined as acute if diagnosed ≤7 days post LAAC (n = 3, 2.3%) or delayed if diagnosed >7 days post LAAC (n = 3, 2.3%). The clinical characteristics and procedural data were compared between patients with PE (PE group, n = 6) and without PE (non-PE group, n = 127). The predictors of PE were analyzed by logistic regression.ResultsAll patients with PE recovered following treatment by pericardiocentesis. Patients with PE were found to have a higher incidence of congestive heart failure (50.0% vs. 13.4%, P = 0.044) and had larger measured LAA orifice diameters (33.5 mm ± 6.0 mm vs. 28.3 mm ± 5.2 mm, P = 0.018) and landing zone diameters (27.8 mm ± 4.8 mm vs. 23.9 mm ± 4.8 mm, P = 0.054) compared with those without PE. The diameters of the device umbrellas (31.7 mm ± 5.6 mm vs. 26.9 mm ± 5.0 mm, P = 0.026) and covers (36.3 mm ± 4.6 mm vs. 33.4 mm ± 4.0 mm, P = 0.075) implanted were larger in the PE group compared to the non-PE group. Univariate logistic regression revealed that congestive heart failure (OR = 6.47, 95% CI = 1.21–34.71, P = 0.029) and LAA maximal orifice diameter (OR = 1.22, 95% CI = 1.02–1.45, P = 0.027) were both associated with PE following LAmbre device implantation.ConclusionsIn this single-center experience, both acute and delayed PE were uncommon in patients with AF following LAmbre device implantation. Congestive heart failure and a larger LAA orifice were identified as predictors for the occurrence of PE.

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Section: Discussionmentioning

confidence: 99%

Pericardial effusion following percutaneous left atrial appendage closure using the LAmbre device

Chu

Wang

et al. 2023

Front. Cardiovasc. Med.

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“…There are two methods for LAAC: surgical closure and catheter-based closure using a device to plug the LAA. Although device implantation into the LAA is well established and a less invasive method for LAAC, it is limited by the size and morphology of the LAA 8. Continuous anticoagulation management is also necessary for device implantation until the endothelial coverage is completed.…”

Section: Discussionmentioning

confidence: 99%

“…Although device implantation into the LAA is well established and a less invasive method for LAAC, it is limited by the size and morphology of the LAA. 8 Continuous anticoagulation management is also necessary for device implantation until the endothelial coverage is completed. As this patient suffered from bladder bleeding, anticoagulation therapy had to be stopped immediately.…”

Section: Discussionmentioning

confidence: 99%

Concomitant surgery of minimally invasive direct coronary artery bypass with left atrium appendage closure

Goto,

Takagi,

Yanagisawa

et al. 2023

BMJ Case Rep

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Surgical approaches of minimally invasive direct coronary artery bypass and left atrial appendage exclusion are different, and issues may arise in cases of concomitant surgery. Moreover, the safety of concomitant procedures has not been established. A man in his 80s with a history of stroke required minimally invasive coronary artery bypass grafting and left atrial appendage closure for the stenosis of the left anterior descending artery and atrial fibrillation. He suffered from bladder bleeding, which required early reduction of anticoagulant and antiplatelet medication. Therefore, he wished for surgical treatment. A lateral incision was necessary for left atrial appendage closure in minimally invasive surgery. We performed totally endoscopic harvest of the internal thoracic artery without a robotic system. This method allowed the incision to be made more laterally. Combining the endoscopic harvest of the internal mammary artery with left atrial appendage closure via lateral incision may be a reasonable technique.

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“…LAA ligation via epicardial clipping or snaring can often be incomplete and lead to potential thrombus formation and embolization [ 21 ]. Incomplete ligation by either endocardial occluder devices or by extrinsic ligation can be treated with coils or additional closure devices, but these products can create problems on their own including clotting on the surface [ 13 , 22 ] and typically require systemic anticoagulation treatment. Similarly, device-related thrombus -related to activation of the extrinsic coagulation system on the device surface upon contact with blood-can lead to embolism and potential stroke [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Thermally responsive hydrogel for atrial fibrillation related stroke prevention

Hendrickson

Lupo

Bauza

et al. 2022

Materials Today Bio

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Left atrial appendage orifice diameter measured with trans-esophageal echocardiography is independently related with peri-device leakage after Watchman device implantation

Cited by 10 publications

References 27 publications

Pericardial effusion following percutaneous left atrial appendage closure using the LAmbre device

Pericardial effusion following percutaneous left atrial appendage closure using the LAmbre device

Concomitant surgery of minimally invasive direct coronary artery bypass with left atrium appendage closure

Thermally responsive hydrogel for atrial fibrillation related stroke prevention

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