Percutaneous left atrial appendage closure with complex anatomy by using the staged 'kissing-Watchman' technology with double devices
Copyright © 2018 Elsevier B.V. All rights reserved..
BACKGROUND: Left atrial appendage closure (LAAC) is an efficient alternative of oral anticoagulation to prevent stroke in patients with non-valvular atrial fibrillation (NVAF). Due to complexities of LAA anatomy, a complete closure may not always be obtained with a single device. The aim of this study was to evaluate the feasibility and safety of the staged 'kissing-Watchman' technology to occlude the LAA with complex anatomy.
METHODS: In our center, among 300 cases underwent LAAC with Watchman device from February 2012 to December 2016, 7 complex LAAs were implanted double devices using the staged 'kissing-Watchman' technology. The anatomic morphology, procedure characteristics and safety were analyzed.
RESULTS: Of the 7 LAAs, the anatomic morphology includes 6 cauliflowers and 1 chicken wings, each has 2 big lobes and a large common ostium. In the two-staged LAAC procedures, there were no differences in X-ray exposure time, but the total procedure time (p = 0.0634), contrast volume (p = 0.0802) and X-ray dose (p = 0.0803) in the first procedure showed a tendency over the second. All the procedures were successful, except for one case with a 2 mm of peri-device leakage, there were no severe complications or major adverse events including device dislocation, thrombosis, obvious peri-device leakage (≥5 mm), pericardial effusion/tamponade, stroke/transient ischemic attack/systemic embolism, death and major bleeding during the 7-day perioperative period and the 6-month follow-up.
CONCLUSIONS: The staged 'kissing-Watchman' technology is feasible and safe, which might provide a strategy to occlude the LAA with complex anatomy when an incomplete closure is inevitable with a single device.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:265 |
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| Enthalten in: |
International journal of cardiology - 265(2018) vom: 15. Aug., Seite 58-61 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jiang, Lisheng [VerfasserIn] |
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| Anmerkungen: |
Date Completed 14.01.2019 Date Revised 14.01.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2018.05.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM28401639X |
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| 245 | 1 | 0 | |a Percutaneous left atrial appendage closure with complex anatomy by using the staged 'kissing-Watchman' technology with double devices |
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| 500 | |a Date Revised 14.01.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Left atrial appendage closure (LAAC) is an efficient alternative of oral anticoagulation to prevent stroke in patients with non-valvular atrial fibrillation (NVAF). Due to complexities of LAA anatomy, a complete closure may not always be obtained with a single device. The aim of this study was to evaluate the feasibility and safety of the staged 'kissing-Watchman' technology to occlude the LAA with complex anatomy | ||
| 520 | |a METHODS: In our center, among 300 cases underwent LAAC with Watchman device from February 2012 to December 2016, 7 complex LAAs were implanted double devices using the staged 'kissing-Watchman' technology. The anatomic morphology, procedure characteristics and safety were analyzed | ||
| 520 | |a RESULTS: Of the 7 LAAs, the anatomic morphology includes 6 cauliflowers and 1 chicken wings, each has 2 big lobes and a large common ostium. In the two-staged LAAC procedures, there were no differences in X-ray exposure time, but the total procedure time (p = 0.0634), contrast volume (p = 0.0802) and X-ray dose (p = 0.0803) in the first procedure showed a tendency over the second. All the procedures were successful, except for one case with a 2 mm of peri-device leakage, there were no severe complications or major adverse events including device dislocation, thrombosis, obvious peri-device leakage (≥5 mm), pericardial effusion/tamponade, stroke/transient ischemic attack/systemic embolism, death and major bleeding during the 7-day perioperative period and the 6-month follow-up | ||
| 520 | |a CONCLUSIONS: The staged 'kissing-Watchman' technology is feasible and safe, which might provide a strategy to occlude the LAA with complex anatomy when an incomplete closure is inevitable with a single device | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Duenninger, Erich |e verfasserin |4 aut | |
| 700 | 1 | |a Muenzel, Manuela |e verfasserin |4 aut | |
| 700 | 1 | |a Xue, Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Fazakas, Adam |e verfasserin |4 aut | |
| 700 | 1 | |a Keil, Thorsten |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Jiangtao |e verfasserin |4 aut | |
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