Journal ArticleDOI
Left atrial appendage closure with AMPLATZER cardiac plug for stroke prevention in atrial fibrillation: initial Asia-Pacific experience.
Yat-Yin Lam,Gabriel W.K. Yip,Cheuk-Man Yu,Wilson W.M. Chan,Boron Cheung Wah Cheng,Bryan P. Yan,R. Clugston,Gerald Yong,Tim Gattorna,Vincent Paul +9 more
Reads0
Chats0
TLDR
The preliminary data suggested LAA closure with ACP is safe, feasible with encouraging 1‐yr clinical outcomes, and further large‐scaled trials are needed to confirm the efficacy of this device.Abstract:
Background: Left atrial appendage (LAA) is the main source of left atrial thrombus that causes stroke in patients with non-valvular atrial fibrillation (NVAF). This study reported the initial safety, feasibility, and 1-yr clinical outcomes following AMPLATZER cardiac plug (ACP) implantation in Asia-Pacific region.Methods: Twenty NVAF patients (16 males, age 68 ± 9 yr) with high risk for developing cardioembolic stroke (CHADS2 score: 2.3 ± 1.3) and contraindications to warfarin received ACP implants from June 2009 to May 2010. Patients received general anesthesia (n = 9) or controlled propofol sedation (n = 11) and the procedures were guided by fluoroscopy and transesophageal echocardiography (TEE). Clinical follow-up was arranged at 1 month and then every 3 months after implantation, whereas, a TEE was scheduled at 1 month upon completion of dual anti-platelet therapy.Results: The LAA was successfully occluded in 19/20 patients (95%) at two Asian centers. One procedure was abandoned because of catheter-related thrombus formation. Other complications included coronary artery air embolism (n = 1) and TEE-attributed esophageal injury (n = 1). The median procedural and fluoroscopic times were 79 (IQR: 59–100) and 18 (IQR 12–27) minutes, respectively. The mean size of implant was 23.6 ± 3.1 mm. The average hospital stay was 1.8 ± 1.1 days. Follow-up TEE showed all the LAA orifices were sealed without device-related thrombus formation. No stroke or death occurred at a mean follow-up of 12.7 ± 3.1 months. Conclusions: Our preliminary data suggested LAA closure with ACP is safe, feasible with encouraging 1-yr clinical outcomes. Further large-scaled trials are needed to confirm the efficacy of this device. © 2011 Wiley Periodicals, Inc.read more
Citations
More filters
Journal ArticleDOI
Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation☆
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
Journal ArticleDOI
EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion
Bernhard Meier,Yuri Blaauw,Ahmed A. Khattab,Torsten Lewalter,Horst Sievert,Claudio Tondo,Michael Glikson +6 more
TL;DR: The CHADS2 score was established to assess the risk of thrombo-embolic events in patients with AF of non-valvular origin and the CHA2DS2-VASc score has recently been introduced and adopted to improve risk stratification in the low-risk group.
Journal ArticleDOI
Percutaneous Left Atrial Appendage Closure With the AMPLATZER Cardiac Plug Device in Patients With Nonvalvular Atrial Fibrillation and Contraindications to Anticoagulation Therapy
Marina Urena,Josep Rodés-Cabau,Xavier Freixa,Jacqueline Saw,John G. Webb,Melanie Freeman,Eric Horlick,Mark Osten,Albert W. Chan,Jean-Francois Marquis,Jean Champagne,Reda Ibrahim +11 more
TL;DR: In patients with nonvalvular atrial fibrillation at high risk of cardioembolic events and absolute contraindications to anticoagulation, LAAC using the ACP device followed by dual-/single-antiplatelet therapy was associated with a low rate of embolic and bleeding events after a mean follow-up of 20 months.
Journal ArticleDOI
Incidence and Clinical Impact of Device-Associated Thrombus and Peri-Device Leak Following Left Atrial Appendage Closure With the Amplatzer Cardiac Plug.
Jacqueline Saw,Apostolos Tzikas,Samera Shakir,Sameer Gafoor,Heyder Omran,Jens Erik Nielsen-Kudsk,Joelle Kefer,Adel Aminian,Sergio Berti,Gennaro Santoro,Fabian Nietlispach,Aris Moschovitis,Ignacio Cruz-Gonzalez,Francis Stammen,Tobias Tichelbäcker,Xavier Freixa,Reda Ibrahim,Wolfgang Schillinger,Bernhard Meier,Horst Sievert,Steffen Gloekler +20 more
TL;DR: Following successful left atrial appendage closure with the Amplatzer Cardiac Plug, the presence of peri-device leak was relatively low, and device-associated thrombus was infrequent, and neither was associated with increased risk for thromboembolism.
Journal ArticleDOI
Percutaneous Left Atrial Appendage Closure: Procedural Techniques and Outcomes
TL;DR: Percutaneous left atrial appendage closure technology for stroke prevention in patients with atrial fibrillation has significantly advanced in the past 2 decades and the procedural techniques, safety, and outcomes of the current leading devices are reviewed.
References
More filters
Journal ArticleDOI
Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.
TL;DR: The data suggest that the elderly are particularly vulnerable to stroke when atrial fibrillation is present, and the effects of hypertension, coronary heart disease, and cardiac failure on the risk of stroke became progressively weaker with increasing age.
Journal ArticleDOI
Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.
Journal ArticleDOI
The Framingham study.
TL;DR: The stroke profile can be used for evaluation of the risk of stroke and suggestion of risk factor modification to reduce risk.
Journal ArticleDOI
Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial
David R. Holmes,Vivek Y. Reddy,Zoltan G. Turi,Shephal K. Doshi,Horst Sievert,Maurice Buchbinder,Christopher M. Mullin,Peter Sick +7 more
TL;DR: The efficacy of percutaneous closure of the LAA with this device was non-inferior to that of warfarin therapy and there was a higher rate of adverse safety events in the intervention group than in the control group, which were mainly a result of periprocedural complications.
Journal ArticleDOI
Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation☆
Brian F. Gage,Amy D. Waterman,William D. Shannon,Michael Boechler,Michael W. Rich,Martha J. Radford +5 more
TL;DR: The 2 existing classification schemes and especially a new stroke risk index, CHADS, can quantify risk of stroke for patients who have AF and may aid in selection of antithrombotic therapy.