Amplatzer left atrial appendage closure: Single versus combined procedures
| Autor: | Bernhard Meier, Caroline Kleinecke, Steffen Gloekler, Samuel R Streit, Roberto Galea, Eric Buffle, Jonas Dominik Häner, Juergen Link, Stephan Windecker, Alexander Sedaghat |
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| Rok vydání: | 2020 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Percutaneous Septal Occluder Device medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Left atrial Atrial Fibrillation medicine Humans Atrial Appendage Radiology Nuclear Medicine and imaging 030212 general & internal medicine 610 Medicine & health Aged business.industry Atrial fibrillation General Medicine Clipping (medicine) medicine.disease Ablation University hospital Surgery Stroke Treatment Outcome Patent foramen ovale Cardiology and Cardiovascular Medicine business Major bleeding |
| Zdroj: | Catheterization and Cardiovascular Interventions. 97 |
| ISSN: | 1522-726X 1522-1946 |
| DOI: | 10.1002/ccd.29271 |
| Popis: | OBJECTIVES This study compares procedural and late clinical outcomes of left atrial appendage closure (LAAC) with Amplatzer devices as a single versus a combined procedure with other structural or coronary interventions. BACKGROUND Multiple cardiac conditions are frequent among elderly patients and invite simultaneous treatment to ensure a favorable patient outcomes. METHODS 559 consecutive patients (73.3��������11.1���years) underwent LAAC with Amplatzer devices at two centres (Bern and Zurich university hospitals, Switzerland) either as a single procedure or combined with other interventions. The primary safety endpoint was a composite of major peri-procedural complications and major bleeding at follow-up, the primary efficacy endpoint included stroke, systemic embolism, and cardiovascular/unexplained death. All event rates are reported per 100 patient-years. RESULTS In 263 single and 296 combined procedures with percutaneous coronary interventions (47.6%), closure of an atrial septal defect (8.4%) or a patent foramen ovale (36.5%), transcatheter aortic valve implantation (10.1%), mitral clipping (4.1%), atrial fibrillation ablation (8.8%), or another procedure (3.0%) were analyzed. Device success (96.6% [single] vs. 99.0% [combined], p��=��.08) did not differ between the groups. After a mean follow-up of 2.6��������1.5 vs. 2.5��������1.5���years and a total of 1,422 patient-years, the primary efficacy (40/677, 5.9% [single] vs. 37/745, 5.0% [combined]; HR, 1.2, 95% CI, 0.8-1.9, p��=��.44), as well as the primary safety endpoint (25/677, 3.7% vs 28/745, 3.8%; HR, 1.0, 95% CI, 0.6-1.8, p��=��.89) were comparable. CONCLUSIONS LAAC with Amplatzer devices combined with structural, coronary, and electrophysiological procedures offers procedural feasibility and safety, as well as long-term efficacy. |
| Databáze: | OpenAIRE |
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