TriGuard Embolic Protection Device in percutaneous cardiac interventions with intracavitary cardiac thrombosis: A case series

Marcon, Lorenzo; Sicuso, Rita; Galli, Stefano; Majocchi, Benedetta; Carbucicchio, Corrado; Tondo, Claudio; Fassini, Gaetano

doi:10.1111/pace.14712

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…A partial umbrella delivery of a LAmbre 24/30 mm was done in front of LAA ostium and the whole system was advanced up to the point immediately before thrombus in LAA superior lobe [ 34 ] Kaczmarek 2021 Watchman = 2 Watchman FLX = 2 ACP = 13 N/A N/A N/A 17 TEE and fluoroscopy No LAA angiography in 8 cases. 5 cases underwent LAA angiographies with gentle hand contrast injections through pigtail catheters [ 35 ] Marcon 2023 Watchman FLX = 6 N/A N/A 6 6 TEE or ICE “One shot technique” and a stepwise approach based on continuous ICE monitoring (It consists of ICE guided trans-septal puncture and guidewire advancement within the left superior pulmonary vein; exchange with long delivery sheath; trans-septal crossing with the ICE probe, reaching the point allowing the best LAA view (usually at the LSPV ostium); LAA occluder sizing based on landing zone measurement and LAA occluder deploy under ICE monitoring) [ 36 ] Cruz-Gonzalez 2017 Lambre = 1 N/A N/A 1 1 TEE and fluoroscopy Partial deployment of device at the LAA ostium and it was advanced under simultaneous counterclockwise rotation [ 37 ] Cammalleri 2016 ACP = 1 N/A N/A 1 1 TEE Standard endocardial LAAC procedure [ 38 ] Pak 2013 ACP = 1 N/A N/A N/A 1 TEE Transseptal sheath was advanced into LSPV ...…”

Section: Resultsmentioning

confidence: 99%

Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure

Zhang,

Zhou,

Lin

et al. 2024

BMC Cardiovasc Disord

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Background Approximately 90% of intracardial thrombi originate from the left atrial appendage in non-valvular atrial fibrillation patients. Even with anticoagulant therapy, left atrial appendage thrombus (LAAT) still occurs in 8% of patients. While left atrial appendage closure (LAAC) could be a promising alternative, the current consensus considers LAAT a contraindication to LAAC. However, the feasibility and safety of LAAC in patients with LAAT have yet to be determined. Methods This systematic review synthesizes published data to explore the feasibility and safety of LAAC for patients with LAAT. Results This study included a total of 136 patients with LAATs who underwent successful LAAC. The Amulet Amplatzer device was the most frequently utilized device (48.5%). Among these patients, 77 (56.6%) had absolute contraindications to anticoagulation therapy. Cerebral protection devices were utilized by 47 patients (34.6%). Transesophageal echocardiography (TEE) is the primary imaging technique used during the procedure. Warfarin and novel oral anticoagulants were the main anticoagulant medications used prior to the procedure, while dual antiplatelet therapy was primarily used post-procedure. During a mean follow-up period of 13.2 ± 11.5 months, there was 1 case of fatality, 1 case of stroke, 3 major bleeding events, 3 instances of device-related thrombus, and 8 cases of peri-device leakage. Conclusions This review highlights the preliminary effectiveness and safety of the LAAC procedure in patients with persistent LAAT. Future large-scale RCTs with varied LAAT characteristics and LAAC device types are essential for evidence-based decision-making in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure

Zhang,

Zhou,

Lin

et al. 2024

BMC Cardiovasc Disord

View full text Add to dashboard Cite

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Protección cerebral en el cierre percutáneo de orejuela: a propósito de un caso

Poza Gonzalez,

Massanet Delgado,

Sierra Ojeda

2023

Enferm Cardiol

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La fibrilación auricular es la arritmia más común. La complicación más grave que presenta es el accidente cerebrovascular, pero existen otros problemas asociados a la necesidad de anticoagulación oral. Una alternativa para estos pacientes es la realización de un cierre de orejuela izquierda: especialmente indicada en aquellos pacientes con antecedentes de accidentes cerebrovasculares o sangrados recurrentes por la toma de anticoagulantes orales. La fibrilación auricular crónica suele estar asociada a la formación de trombos en la orejuela situada en la aurícula izquierda del corazón. El tratamiento intervencionista estaría indicado tras la disolución del trombo mediante terapia farmacológica. Si esta disolución no se ha podido completar, el cierre percutáneo conlleva un riesgo asociado, con mayor probabilidad de lesiones cerebrovasculares o ictus. Para evitar un accidente cerebrovascular intraprocedimiento, se han diseñado diferentes dispositivos de protección cerebral. Se describe el caso de un paciente con fibrilación auricular con antecedentes de sangrado digestivo que se somete a un cierre percutáneo de orejuela de forma electiva. Para reducir los riesgos asociados, se propuso el uso del dispositivo de protección embólica cerebral TriGUARD 3. Se elaboró un plan de cuidados individualizados aplicando la taxonomía NANDA-NOC-NIC. Palabras clave: fibrilación auricular, apéndice atrial, enfermería cardiovascular, atención de enfermería, accidente cerebrovascular, dispositivos de protección embólica.

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TriGuard Embolic Protection Device in percutaneous cardiac interventions with intracavitary cardiac thrombosis: A case series

Cited by 2 publications

References 18 publications

Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure

Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure

Protección cerebral en el cierre percutáneo de orejuela: a propósito de un caso

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