Intra-Cardiac versus Transesophageal Echocardiographic Guidance for Left Atrial Appendage Occlusion with a Watchman FLX Device.

Autor: Pastormerlo LE; Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy., Tondo C; Department of Clinical Electrophysiology and Cardiac Pacing, Heart Rhythm Center at Monzino Cardiac Center, IRCCS, 20138 Milan, Italy., Fassini G; Department of Clinical Electrophysiology and Cardiac Pacing, Heart Rhythm Center at Monzino Cardiac Center, IRCCS, 20138 Milan, Italy., Nicosia A; Dipartimento Cardio-Neuro-Vascolare, Ospedale GP II-Asp di Ragusa, 97100 Ragusa, Italy., Ronco F; Ospedale dell'Angelo di Mestre, 30174 Venice, Italy., Contarini M; Cardiology Department, Umberto I Hospital, ASP 8 Siracusa, 96100 Syracuse, Italy., Giacchi G; Cardiology Department, Umberto I Hospital, ASP 8 Siracusa, 96100 Syracuse, Italy., Grasso C; AOU Policlinico 'G. Rodolico-San Marco', Centro Alte Specialità e Trapianti-C.A.S.T., 95123 Catania, Italy., Casu G; Cardiologia Clinica e Interventistica, Azienda Ospedaliero Universitaria Sassari, 07100 Sassari, Italy., Romeo MR; Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy., Mazzone P; Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy., Limite L; Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy., Caramanno G; Ospedale San Giovanni di Dio, 92100 Agrigento, Italy., Geraci S; Ospedale San Giovanni di Dio, 92100 Agrigento, Italy., Pagnotta P; Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.; Humanitas Research Hospital IRCCS, 20089 Rozzano, Italy., Chiarito M; Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.; Humanitas Research Hospital IRCCS, 20089 Rozzano, Italy., Tamburino C; AOU Policlinico 'G. Rodolico-San Marco', Centro Alte Specialità e Trapianti-C.A.S.T., 95123 Catania, Italy., Berti S; Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Oct 20; Vol. 12 (20). Date of Electronic Publication: 2023 Oct 20.
DOI: 10.3390/jcm12206658
Abstrakt: This study aimed to compare the peri-procedural success and complication rate within a large registry of intra-cardiac echocardiography (ICE)- vs. transesophageal echocardiography (TEE)-guided left atrial appendage occlusion (LAAO) procedures with a Watchmann FLX device. Data from 772 LAAO procedures, performed at 26 Italian centers, were reviewed. Technical success was considered as the final implant of a Watchmann FLX device in LAA; the absence of pericardial tamponade, peri-procedural stroke and/or systemic embolism, major bleeding and device embolization during the procedure was defined as a procedural success. One-year stroke and major bleeding rates were evaluated as outcome. ICE-guided LAA occlusion was performed in 149 patients, while TEE was used in 623 patients. Baseline characteristics were similar between the ICE and TEE groups. The technical success was 100% in both groups. Procedural success was also extremely high (98.5%), and was comparable between ICE (98.7%) and TEE (98.5%). ICE was associated with a slightly longer procedural time (73 ± 31 vs. 61.9 ± 36 min, p = 0.042) and shorter hospital stay (5.3 ± 4 vs. 5.8 ± 6 days, p = 0.028) compared to the TEE group. At one year, stroke and major bleeding rates did not differ between the ICE and TEE groups. A Watchmann FLX device showed high technical and procedural success rate, and ICE guidance does not appear inferior to TEE.
Databáze: MEDLINE
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