Transcatheter Left Atrial Appendage Closure After Incomplete Surgical Ligation

Matsumoto, Takashi; Nakamura, Mamoo; Yeow, Wen–Loong; Siegel, Robert J.; Kar, Saibal

doi:10.1016/j.jcin.2012.09.015

Cited by 8 publications

(3 citation statements)

References 1 publication

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“…In this case report, complete percutaneous closure can be achieved with a septal occluder following the LARIAT device. This technique is a feasible approach and corroborates our previous experience with incomplete surgical ligation . The Gore Helex septal occluder, unlike the Amplazter® septal occluder (St Jude Medical, St Paul, MN), is made from a single nitinol wire frame that is covered with expandable polytetrafluoroethylene, which is considered to have low thrombogenicity.…”

Section: Discussionsupporting

confidence: 73%

“…With knowledge of the significant residual gap, two options were considered: the first was a reattempt at percutaneous LAA suture ligation; the second being transseptal endovascular closure with a septal closure device. Based on our previous experience we felt that the second approach was more feasible . Through the previous TSP site, a 65‐cm long 10 Fr braided sheath (Arrow International, Reading, PA) was advanced into the left atrium.…”

Section: Case Reportmentioning

confidence: 99%

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Successful closure of residual leak following lariat procedure in a patient with high risk of stroke and hemorrhage

Yeow

Matsumoto

Kar

2013

Cathet Cardio Intervent

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Percutaneous left atrial appendage suture ligation with the LARIAT® device (Sentre HEART, Redwood City, CA) was successfully performed on an 84-year-old woman with non-valvular atrial fibrillation who developed intracranial hemorrhage on warfarin. However, a large gap developed at follow-up precluding warfarin cessation. To the best of our knowledge, this case report represents the first description of the use of a Gore® Helex® Septal Occluder (W. L. Gore and Associates, Newark, Delaware) as a novel approach to close a gap following percutaneous LAA suture ligation.

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Section: Discussionsupporting

confidence: 73%

Section: Case Reportmentioning

confidence: 99%

Successful closure of residual leak following lariat procedure in a patient with high risk of stroke and hemorrhage

Yeow

Matsumoto

Kar

2013

Cathet Cardio Intervent

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“…Similar to 3 of our patients, the Amplatzer Septal Occluder was successfully used in 6 of 7 cases in a series of patients with incomplete surgical LAA ligation, [9] as well as in 5 of 6 patients with persistent LA-LAA connection after an initial Lariat procedure. [10] Other case series have demonstrated the use of alternate devices for this purpose, including the Gore Helex septal occluder, [11] a vascular plug, [12] the AGA Cardiac plug, [13] and the WATCHMAN device. [14] Our study adds to this body of literature and provides a useful method of entering the LAA through a small neck using an ablation catheter for support.…”

Section: Discussionmentioning

confidence: 99%

Closure of Residual Left Atrial Appendage Communications After a Prior Exclusion Attempt

Hucker

Bapat

Hanley

et al. 2021

Preprint

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Background: Surgical or percutaneous occlusion of the left atrial appendage (LAA) is increasingly used for thromboembolic protection in atrial fibrillation. Incomplete LAA closure may increase risk of thrombosis and thromboembolism, and therefore approaches to address residual communications are needed. Objective: To analyze the technique of closing an incompletely occluded LAA and subsequent patient outcomes. Methods: We performed a retrospective analysis of 5 consecutive patients who presented for completion of LAA closure. Results: Four patients were male, mean age 75, average CHA2DS2-VASc score 5.4, and four had prior surgical LAA ligation. One patient had previously had a WATCHMAN device placed for whom a 3D printed model was created from preprocedural imaging data to guide Amplatzer occluder device selection for closure. The residual LAA communication maximal diameter averaged 6.2 mm (range 5-8mm). In 4 of 5 cases, an ablation catheter was used to enter the LAA. The residual LAA communication was closed with either an Amplatzer occluder (n=3) or a WATCHMAN device (n=2). No procedural complications occurred, and no residual leak remained afterwards. No neurologic events occurred during follow up (average 603 days, range 155-1177 days). Anticoagulation or dual antiplatelet therapy was stopped following a transesophageal echo (TEE) ³ 6 weeks after the procedure demonstrated no residual communication in 4 of 5 patients, and after 20 weeks in the fifth patient without a follow up TEE. Conclusion: Large residual LAA communications after LAA occlusion attempts can be successfully and safely closed percutaneously using either Amplatzer occluder devices or WATCHMAN devices.

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Safety and effectiveness of compassionate use of LARIAT® device for epicardial ligation of anatomically complex left atrial appendages

Patel

Rasekh

Shuraih

et al. 2015

J Interv Card Electrophysiol

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Transcatheter Left Atrial Appendage Closure After Incomplete Surgical Ligation

Cited by 8 publications

References 1 publication

Successful closure of residual leak following lariat procedure in a patient with high risk of stroke and hemorrhage

Successful closure of residual leak following lariat procedure in a patient with high risk of stroke and hemorrhage

Closure of Residual Left Atrial Appendage Communications After a Prior Exclusion Attempt

Safety and effectiveness of compassionate use of LARIAT® device for epicardial ligation of anatomically complex left atrial appendages

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