Left atrial appendage occlusion: Initial experience with the Amplatzer™ Amulet™
| Autor: | Xavier Freixa, Ali Abualsaud, Reda Ibrahim, Apostolos Tzikas, Jason Chan, Mohamed Nosair, Patrick Garceau, Arsène Basmadjian |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Percutaneous Septal Occluder Device medicine.medical_treatment Left atrial appendage occlusion Pericardial effusion Percutaneous Coronary Intervention Left atrial Occlusion medicine Humans Atrial Appendage Prospective Studies Stroke Contraindication Aged Ultrasonography Aged 80 and over business.industry Atrial fibrillation medicine.disease Surgery Radiography Treatment Outcome Female Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 174:492-496 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2014.03.154 |
| Popis: | Background The Amplatzer™ Amulet™ (Amulet) is the evolution of the Amplatzer™ Cardiac Plug, a dedicated device for percutaneous left atrial appendage (LAA) occlusion. The new device has been designed to facilitate the implantation process, improve the sealing performance and further reduce the risk of complications. The objective of the study was to describe the initial experience with the Amplatzer Amulet for percutaneous LAA occlusion. Methods This was a prospective single-center study of patients undergoing percutaneous LAA occlusion. The indication for LAA closure was a formal contraindication for oral anticoagulation or previous history of stroke due to INR lability. All procedures were done under general anesthesia and transesophageal echocardiography (TEE) guidance. Transthoracic echocardiography was performed 24 h after the procedure in order to rule out procedural complications before discharge. Further follow-up was done with a clinical visit and TEE at 1–3 months. Results Between July-2012 and June-2013, 25 patients with a mean CHA2DS2-VASC of 4.3 ± 1.7 underwent LAA occlusion with the Amplatzer Amulet. The device was successfully implanted in 24 patients (96%) without any procedural stroke, pericardial effusion or device embolization. None of the patients presented any clinical event at follow-up. Follow-up TEE showed complete LAA sealing in all patients with no residual leaks > 3 mm and no device embolization. One patient (4.1%) presented a device thrombosis at follow-up without clinical expression. Conclusion In this initial series of patients, the Amulet showed a remarkable acute and short-term performance in terms of feasibility and safety as depicted by the high successful implantation rate and the low incidence of complications. |
| Databáze: | OpenAIRE |
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