Patient-specific catheter shaping for the minimally invasive closure of the left atrial appendage

2018 ◽  
Vol 13 (6) ◽  
pp. 837-846
Author(s):  
Eva C. Graf ◽  
Ilka Ott ◽  
Julian Praceus ◽  
Felix Bourier ◽  
Tim C. Lueth
Keyword(s):  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Patient Specific

Advanced Manufacturing of Patient‐Specific Occluders for the Left Atrial Appendage with Minimally Invasive Delivery

2020 ◽  
Vol 22 (5) ◽  
pp. 1901074
Author(s):  
Seyedhamidreza Alaie ◽  
Sanlin S. Robinson ◽  
Amir Ali Amiri Moghadam ◽  
Jordyn Augé ◽  
Alexandre Caprio ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Patient Specific ◽  
Advanced Manufacturing

scholarly journals Angiographic Efficacy of the Atriclip Left Atrial Appendage Exclusion Device Placed by Minimally Invasive Thoracoscopic Approach

2017 ◽  
Vol 3 (12) ◽  
pp. 1356-1365 ◽  
Author(s):  
Christopher R. Ellis ◽  
Sam G. Aznaurov ◽  
Neel J. Patel ◽  
Jennifer R. Williams ◽  
Kim Lori Sandler ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Thoracoscopic Approach

Surgical Treatment of Isolated (Lone) Atrial Fibrillation with Gemini-S Ablation and Left Atrial Appendage Excision (GALAXY Procedure)

2012 ◽  
Vol 7 (1) ◽  
pp. 33-38 ◽  
Author(s):  
John R. Doty ◽  
Stephen E. Clayson
Keyword(s):  
Atrial Fibrillation ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Atrial Appendage ◽  
Lone Atrial Fibrillation ◽  
Surgical Ablation ◽  
Invasive Approach ◽  
The Galaxy

Objective Surgical ablation with radiofrequency is a safe and effective treatment for atrial fibrillation. Recent advances in instrumentation have allowed for the application of bipolar radiofrequency through a minimally invasive approach using small bilateral thoracotomies for pulmonary vein isolation, destruction of autonomic ganglia, and excision of the left atrial appendage (GALAXY procedure). Methods Thirty-two patients underwent surgical ablation of atrial fibrillation with the GALAXY procedure over a 43-month period. Data were collected in a prospective manner during hospitalization and at 1-, 3-, 6-, and 12-month intervals for rhythm, medications, and subsequent interventions. Results There were no operative mortality, no myocardial infarction, and no stroke. One patient required reexploration for bleeding. Mean follow-up was 28 months (range, 4–43 months). Freedom from atrial fibrillation at 12 and 24 months, respectively, was 90% and 67% for patients with paroxysmal fibrillation and 80% and 63% for patients with persistent atrial fibrillation. Of the patients who were not in sinus rhythm, four reverted to atrial fibrillation and two reverted to atrial flutter. Conclusions The GALAXY procedure is a safe and effective, minimally invasive method for treatment of isolated (lone) atrial fibrillation. The operation provides excellent short-term freedom from atrial fibrillation and should be considered in patients with isolated paroxysmal atrial fibrillation.

P2467Fusion imaging (Anatomical Intelligence) enables automated left atrial appendage sizing in real-time a single center pilot study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Afzal ◽  
V Veulemans ◽  
K Hellhammer ◽  
K Piayda ◽  
N Nijhof ◽  
...  
Keyword(s):  
Real Time ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Fusion Imaging ◽  
Atrial Appendage ◽  
Patient Specific ◽  
Heart Model ◽  
Landing Zone ◽  
Device Selection ◽  
The Mean

Abstract Background and purpose Percutaneous left atrial appendage occlusion (LAAO) depicts an alternative treatment for patients with atrial fibrillation who are deemed for long-term oral anticoagulation therapy. In order to perform a successful LAAO accurate sizing of left atrial appendage (ostium, landing zone and depth) for device selection is essential. Echo-Fluoro fusion imaging in real-time offers with its latest prototype a patient-specific segmented automated 3D heart model and sizing of left atrial appendage (LAA). We therefore aimed to evaluate the automated segmented LAA sizing by comparing to 2D transesophageal (TOE) and MSCT measurements as gold standard. Methods We studied prospectively data of 8 consecutive patients who were admitted to our clinic for left atrial appendage closure. MSCT was performed preprocedural and analyzed with commercially available 3mensio software (Pie medical imaging). 2D TOE measurements and automated segmentation of the LAA and sizing were performed during the procedure by a highly experienced team of periinterventional cardiac imaging specialist and structural heart disease interventionalist who were blinded to the prior MSCT analysis. Dimension of ostium, landing zone (10 mm into the LAA parallel to the ostial plane at the level of the left circumflex for Amplatzer device) and depth (perpendicular to the ostial plane) were obtained in different TOE views according to instructions for use of Amulet Occluder. In order to generate an automated 3 D heart model, a high-quality 3D TOE image of the LAA volume and surrounding structures was acquired. After successful ECG-gated segmentation a 3 D heart model was generated. Automated LAA sizing followed in real-time. All measurements were taken into consideration before device selection. A Kruskal Wallis test was used to compare mean ranks of independent samples. A concordance analysis according to Kendall W was carried out to investigate reliability. Results The mean age of the patients was 82,6±4.15 years and half of the patients were female. All procedures were conducted successfully. The mean values of ostium and landing zone were comparable in TOE, automated sizing and MSCT sizing (ostium: 23,78±2,15 mm vs 25,71±5,25 mm vs 27,35±3,3 mm; (p=0,175); landing zone 22,13±3,18 mm vs 23,57±3,31 mm vs 24,00±3,51 mm; (p=0,377)). Furthermore, a significant concordance between the measurements was shown (ostium W= 0,991; p=0.045, landing zone W=0,835, p=0.014). Conclusion Automated LAA sizing acquired by fusion imaging may be an elegant real-time alternative for precise LAA Occluder device selection and needs to be investigated further.

Patient-specific 3D-printed Cardiac Model for Percutaneous Left Atrial Appendage Occlusion

2018 ◽  
Vol 71 (9) ◽  
pp. 762-764 ◽  
Author(s):  
Beatriz Vaquerizo ◽  
Carmen Escabias ◽  
Daniela Dubois ◽  
Gorka Gómez ◽  
Manuel Barreiro-Pérez ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Patient Specific ◽  
Left Atrial Appendage Occlusion ◽  
Cardiac Model ◽  
3D Printed

Left Atrial Appendage Occlusion Pilot Study of a Fourth-Generation, Minimally Invasive Device

2012 ◽  
Vol 7 (3) ◽  
pp. 195-200 ◽  
Author(s):  
Hideyuki Fumoto ◽  
A. Marc Gillinov ◽  
Roberto M. Saraiva ◽  
Tetsuya Horai ◽  
Tomohiro Anzai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Angiography ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Therapeutic Option ◽  
Median Sternotomy ◽  
Atrial Appendage ◽  
Fourth Generation ◽  
Left Circumflex Artery

Objective Exclusion of the left atrial appendage is proposed to reduce the risk of stroke in patients with atrial fibrillation. The aim of this study was to evaluate the feasibility and efficacy of a fourth-generation atrial exclusion device developed for minimally invasive applications. Methods The novel atrial exclusion device consists of two polymer beams and two elastomeric bands that connect the two beams at either end. Fifteen mongrel dogs were implanted with the device at the base of the left atrial appendage through a median sternotomy and were evaluated at 30 (n = 7), 90 (n = 6), and 180 (n = 2) days after implantation by epicardial echocardiography, left atrial and coronary angiography, gross pathology, and histology. Results Left atrial appendage exclusion was completed without hemodynamic instability. Coronary angiography revealed that the left circumflex artery was patent in all cases. A new endothelial tissue layer developed, as expected, on the occluded orifice of the left atrium. Conclusions This novel atrial exclusion device achieved easy, reliable, and safe exclusion of the left atrial appendage, with favorable histological results in a canine model for up to 6 months. Clinical application could provide a new therapeutic option for reducing the risk of stroke in patients with atrial fibrillation.

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