Changes in left atrial appendage orifice following percutaneous left atrial appendage closure using three-dimensional echocardiography.

Autor: Ortiz-Leon XA; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA.; Laboratory of Echocardiography, National Institute of Cardiology, Juan Badiano 1, Belisario Domínguez Secc. 16, 14080, Mexico City, Mexico., Posada-Martinez EL; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA.; Laboratory of Echocardiography, National Institute of Cardiology, Juan Badiano 1, Belisario Domínguez Secc. 16, 14080, Mexico City, Mexico., Bregasi A; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA.; Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 322, Los Angeles, CA, 90033, USA., Chen W; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Crandall I; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Pereira J; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Faridi KF; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Akar JG; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Lin BA; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA.; Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 322, Los Angeles, CA, 90033, USA., McNamara RL; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Freeman JV; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Curtis J; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA., Arias-Godinez JA; Laboratory of Echocardiography, National Institute of Cardiology, Juan Badiano 1, Belisario Domínguez Secc. 16, 14080, Mexico City, Mexico., Sugeng L; Laboratory of Echocardiography, Yale New Haven Hospital, Cardiovascular Division, Yale School of Medicine, 20 York Street, New Haven, CT, 06510, USA. lissa.sugeng@yale.edu.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2022 Jun; Vol. 38 (6), pp. 1361-1369. Date of Electronic Publication: 2022 Jan 22.
DOI: 10.1007/s10554-022-02525-y
Abstrakt: Percutaneous left atrial appendage (LAA) occlusion is increasingly performed in patients with atrial fibrillation and long-term contraindications for anticoagulation. Our aim was to evaluate the effects of LAA occlusion with the Watchman device on the geometry of the LAA orifice and assess its impact on the adjacent left upper pulmonary vein (LUPV) hemodynamics. We included 50 patients who underwent percutaneous LAA occlusion with the Watchman device and had acceptable three-dimensional transesophageal echocardiography images of LAA pre- and post-device placement. We measured offline the LAA orifice diameters in the long axis, and the minimum and maximum diameters, circumference, and area in the short axis view. Eccentricity index was calculated as maximum/minimum diameter ratio. The LUPV peak S and D velocities pre- and post-procedure were also measured. Patients were elderly (mean age 76 ± 8 years), 30 (60%) were men. There was a significant increase of all LAA orifice dimensions following LAA occlusion: diameter 1 (pre-device 18.1 ± 3.2 vs. post-device 21.5 ± 3.4 mm, p < 0.001), diameter 2 (20.6 ± 3.9 vs. 22.1 ± 3.6 mm, p < 0.001), minimum diameter (17.6 ± 3.1 vs. 21.3 ± 3.4 mm, p < 0.001), maximum diameter (21.5 ± 3.9 vs. 22.4 ± 3.6 mm, p = 0.022), circumference (63.6 ± 10.7 vs. 69.6 ± 10.5 mm, p < 0.001), and area (3.1 ± 1.1 vs. 3.9 ± 1.2 cm 2 , p < 0.001). Eccentricity index decreased after procedure (1.23 ± 0.16 vs. 1.06 ± 0.06, p < 0.001). LUPV peak S and D velocities did not show a significant difference (0.29 ± 0.15 vs. 0.30 ± 0.14 cm/s, p = 0.637; and 0.47 ± 0.19 vs. 0.48 ± 0.20 cm/s, p = 0.549; respectively). LAA orifice stretches significantly and it becomes more circular following LAA occlusion without causing a significant impact on the LUPV hemodynamics.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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