Incidence of pericardial effusion after left atrial appendage closure: The impact of underlying heart rhythm-Data from the EWOLUTION study

2018 ◽  
Vol 29 (7) ◽  
pp. 973-978 ◽  
Author(s):  
Boris Schmidt ◽  
Timothy R. Betts ◽  
Horst Sievert ◽  
Martin W. Bergmann ◽  
Stephan Kische ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Heart Rhythm ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
The Impact

scholarly journals Left atrial appendage perforation during appendage angiography treated by percutaneous left atrial appendage closure: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Catherine Champagne ◽  
Nicolas Dognin ◽  
Josep Rodés-Cabau ◽  
Jean Champagne
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Closure Device ◽  
Left Atrial Appendage Closure ◽  
Case Summary ◽  
Device Deployment ◽  
Laa Closure

Abstract Background Pericardial effusion is a common complication of percutaneous left atrial appendage (LAA) closure. Acute management is the cornerstone of pericardial effusion treatment and interrupting the intervention is often required. Case summary A 65-year-old man presented an acute 10 mm pericardial effusion following pigtail contrast appendage injection. A rapid Watchman Flex 24 mm (Boston Scientific) deployment permitted bleeding interruption. A needle pericardiocentesis was achieved in order to prevent any haemodynamical instability. Discussion This case report describes an atypical cause of pericardial effusion and a technique for bleeding control with LAA closure device deployment.

scholarly journals INCIDENCE AND OUTCOMES OF PERICARDIAL EFFUSION/TAMPONADE FOLLOWING PERCUTANEOUS LEFT ATRIAL APPENDAGE CLOSURE

2021 ◽  
Vol 77 (18) ◽  
pp. 1245
Author(s):  
Toshiaki Isogai ◽  
Anas Saad ◽  
Shashank Shekhar ◽  
Abdelrahman Abushouk ◽  
Mohamed Gad ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

OP-033 THE IMPACT OF PERCUTANEOUS LEFT ATRIAL APPENDAGE CLOSURE ON DIASTOLIC FUNCTIONS

2013 ◽  
Vol 163 (3) ◽  
pp. S14
Author(s):  
Ç. Sabanov ◽  
S. Okutucu ◽  
U.N. Karakulak ◽  
M.L. Şahiner ◽  
H. Yorgun ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
The Impact ◽  
Diastolic Functions

Incidence and Outcomes of Pericardial Effusion/Tamponade Following Percutaneous Left Atrial Appendage Closure

2021 ◽  
Vol 160 ◽  
pp. 126-129
Author(s):  
Toshiaki Isogai ◽  
Anas M. Saad ◽  
Shashank Shekhar ◽  
Shunsuke Kuroda ◽  
Abdelrahman I. Abushouk ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

scholarly journals Pericardial Effusion During the Perioperative Period for Left Atrial Appendage Closure

2021 ◽  
Vol 8 ◽  
Author(s):  
Lifan Yang ◽  
Xiaochun Zhang ◽  
Qinchun Jin ◽  
Dehong Kong ◽  
Yuan Zhang ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Positive Association ◽  
Perioperative Period ◽  
Pericardial Tamponade ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Female Sex

Objectives: To analyze the predictors of pericardial effusion (PE) during the perioperative period of the left atrial appendage closure procedure in our center.Methods: A total of 624 consecutive patients with non-valvular AF undergoing LAAC from May 2014 to October 2019 were involved in this study. Patients were divided into groups depending on whether they showed no PE, intraoperative PE or postoperative PE. We analyzed the predictors of PE during the perioperative period of the LAAC procedure.Results: (1) Of the 624 patients in our population (age 68.2 ± 9.1 years, 63% male, CHA2DS2-VASc score 3.4 ± 1.6), 30 patients experienced PE in the perioperative period, including 10 intraoperative PE and 20 postoperative PE. (2) A total of 26 (86.6%) patients had mild PE. 4 (13.4%) patients had pericardial tamponade, 2 (6.7%) of which were intraoperative, and the other 2 (6.7%) postoperative. (3) Significant differences were measured in relation to female sex, intraoperative time, combined procedures, changes in sinus rhythm, device retrieval times and duration of hospitalization between 2 groups (no PE occurred, intraoperative PE), P values were 0.039, 0.024, 0.004, 0.015, 0.003 and 0.039.Conclusions: Female sex, paroxysmal AF, changing in sinus rhythm, device retrieval times and intraoperative time all had a positive association with PE during the perioperative period.

scholarly journals The Impact of Dabigatran and Rivaroxaban on Variation of Platelet Activation Biomarkers and DRT Following Percutaneous Left Atrial Appendage Closure

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoye Li ◽  
Xiaochun Zhang ◽  
Qinchun Jin ◽  
Yanli Li ◽  
Daxin Zhou ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Platelet Reactivity ◽  
Von Willebrand Disease ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Post Procedure ◽  
Increased Risk ◽  
The Impact

Background: The current post-procedure antithrombotic recommendation for left atrial appendage closure (LAAC) remains empiric. This study was designed to compare variations in platelet activation biomarkers and device-related thrombosis (DRT) under different antithrombotic regimens following LAAC.Methods: This study enrolled 105 consecutive patients with atrial fibrillation who underwent LAAC successfully and received post-procedure anticoagulation with either dabigatran (N = 33) or rivaroxaban (N = 72). After 3 months of anticoagulation treatment, thromboelastogram was used to evaluate thrombin receptor–activating peptide (TRAP)–induced platelet aggregation (PA). Measurements of platelet activation biomarkers, including thrombin–antithrombin complex (TAT), P-selectin, von Willebrand disease (vWF), and CD40L, were performed immediately before the LAAC procedure and after 3 months of post-procedure anticoagulation. Repeated transesophageal echocardiography was performed to evaluate DRT during follow-ups.Results: Three (4.2%) patients in the rivaroxaban and 4 (12.1%) patients in the dabigatran group experienced DRT events (odds ratio (OR) = 0.315, 95% confidence interval (95%CI): 0.066–1.489, p = 0.129) during follow-ups. The TRAP-induced PA was statistically significantly higher in the dabigatran group (62.9% vs 59.7%, p = 0.028*). Statistically significant increases in plasma concentration of TAT, P-selectin, and vWF were observed after 3 months of exposure to dabigatran when compared with rivaroxaban. An increased expression of platelet activation biomarkers was observed in DRT subjects compared with non–DRT subjects in terms of P-selectin and vWF (65.28 ± 13.93 ng/L vs 32.14 ± 12.11 ng/L, p = 0.037; 501.92 ± 106.48 U/L vs 280.98 ± 54.10 U/L, p = 0.045; respectively). Multivariate regression analysis indicated that the use of dabigatran might be an independent predictor of DRT (p = 0.022; OR = 4.366, 95%CI: 0.434–10.839). Furthermore, the CHA2DS2-VASc score (OR = 2.076, p = 0.016) and CD40L levels (OR = 1.015, p = 0.021) were independent predictors of increased D-dimer levels.Conclusions: Post-LAAC anticoagulation with dabigatran may increase the risk of DRT by enhancing platelet reactivity. In light of this potential increased risk in DRT, the authors recommend against using dabigatran for post-procedural anticoagulation in patients who have undergone LAAC.

scholarly journals Delayed pericardial effusion after left atrial appendage closure with the LAmbre device: importance of a fully open umbrella

2021 ◽  
Author(s):  
Fangyi Xiao ◽  
yanyan chen ◽  
yi he chen ◽  
Xiaodong Zhou ◽  
Xinlei Wu ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Cox Model ◽  
Combined Treatment ◽  
Pericardial Tamponade ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure ◽  
Modified Method ◽  
Device Implantation

Introduction: We aimed to investigate whether a modified implantation method facilitating a fully open umbrella can reduce the pericardial effusion/pericardial tamponade (PE/PT) rate after left atrial appendage closure (LAAC) with the LAmbre device compared with the conventional method (CM) in patients with non-valvular atrial fibrillation (NVAF). Methods and results: Patients with NVAF who received either isolated LAAC or combined catheter ablation and LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University from January 2018 to December 2019 were enrolled. CM was used for device implantation in the initial 59 patients, while a modified method (MM) was used in the remaining 165 patients. Successful implantation was achieved in 98.3% of patients in the CM group and in 98.8% in the MM group. A higher rate of a fully open umbrella (98.8% vs 69%, P<0.001), less requirement for recapture (46% vs 62.1%, P=0.036), and a lower incidence of delayed PE/PT (1.2% vs 8.6%, P=0.005) were found in the MM group compared with in the CM group. All of the five delayed PT events occurred in patients with combined treatment. An umbrella that was not fully open was the only factor associated with delayed PE/PT events in a multivariable Cox model. Conclusions: LAAC with the LAmbre device using an MM significantly increases the rate of a fully open umbrella and decreases the requirement for recapture and the incidence of delayed PE/PT. This method is more effective in patients with combined treatment.

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