Coronary Angiographic Finding of Thrombus in the Left Atrial Appendage

1996 ◽  
Vol 37 (3P2) ◽  
pp. 749-753 ◽  
Author(s):  
I. Sakamoto ◽  
K. Hayashi ◽  
N. Matsunaga ◽  
Y. Ogawa ◽  
Y. Matsuoka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Atrial ◽  
Heart Surgery ◽  
Left Atrial Appendage ◽  
Open Heart Surgery ◽  
Atrial Appendage ◽  
Open Heart ◽  
Circumflex Artery ◽  
Left Circumflex Artery

Purpose: The value of coronary angiography in the diagnosis of thrombus in the left atrial appendage (LAA) was retrospectively analyzed. Material and Methods: The study covers 34 patients in whom coronary angiography showed coronary neovascularity in LAA with coronary artery-left atrial fistula indicating LAA thrombus. All 34 patients underwent transthoracic echocardiography within one week of coronary angiography. Open-heart surgery was undertaken 2–31 months after angiography in 28 patients. Results: Coronary neovascularity and coronary artery-left atrial fistula arose from the left circumflex artery in 28 patients, and from the left circumflex artery and the right coronary artery in the remaining 6 patients. By echocardiography, LAA thrombus was detected in only one of the 34 patients. In 18 of the 28 patients who underwent open-heart surgery, LAA thrombus was found at surgery to have resolved. Conclusion: Coronary angiography is useful in the diagnosis of LAA thrombus, and coronary neovascularity and fistula formation may indicate that the thrombus can spontaneously resolve.

scholarly journals Perioperative Results from Left Atrial Appendage Removal during Open Heart Surgery

2017 ◽  
Vol 65 (S 01) ◽  
pp. S1-S110
Author(s):  
C. Bening ◽  
K. Hamouda ◽  
M. Leistner ◽  
D. Radakovic ◽  
M. Oezkur ◽  
...  
Keyword(s):  
Left Atrial ◽  
Heart Surgery ◽  
Left Atrial Appendage ◽  
Open Heart Surgery ◽  
Atrial Appendage ◽  
Open Heart

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.

scholarly journals Analiza izvajanja perkutanih koronarnih posegov v 10-letnem obdobju (2005–2015) – izkušnje enega centra

2017 ◽  
Vol 86 (3-4) ◽  
Author(s):  
Ana Reschner ◽  
Maja Rojko ◽  
Hrvoje Reschner ◽  
Igor Zupan ◽  
Andrej Cijan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Confidence Interval ◽  
Heart Surgery ◽  
Stable Coronary Artery Disease ◽  
Open Heart Surgery ◽  
Left Main ◽  
Circumflex Artery ◽  
Femoral Access ◽  
Left Circumflex Artery ◽  
Cardiovascular Center

Background: Medicor was established as the third cardiovascular center in Slovenia and started with percutaneous cardiovascular interventions in 2005. The purpose of our study was to describe the features and results of percutaneous coronary intervention (PCI) performed between 2005 and 2015.Methods: Our retrospective descriptive study included consecutive patients undergoing PCI, who were enrolled in the PCI Registry. Patient characteristics, coronary anatomy, PCI features, use of coronary stents, procedural success and complications were investigated. Special emphasis was put on patients undergoing unprotected left main PCI.Results: During the study period, 1981 PCI procedures were performed. PCI patients were mainly men (73 %), their average age was 65+10 years and a majority (94 %) had stable coronary disease with mutivessel involvement (62 %). PCI was performed on 2978 lesions (1.50 lesion/patient) with an average diameter stenosis of 85+10 %. Target lesion was located either in the left anterior descending artery (42.9 %), right coronary artery (32.4 %), left circumflex artery (18.4 %), left main (3 %), surgical grafs (2.3 %) or in the intermediate artery (1 %). Balloon angioplasty alone was used in 9.6 % while other patients received 1 to 7 stents (1.44+0.86 per patient). Until 2009, drug eluting stents (DES) penetration ranged between 20 % and 30 %. It then increased to 80 % in 2012 and 100 % in 2015. PCI was angiographically successful in 95.2 %. Because of PCI complications, 4 patients (0.2 %) required immediate open-heart surgery and 4 patients (0.2 %) a surgical intervention at the femoral access site. Hospital mortality was 0 %. Stent thrombosis within 30 days was documented in 6 patients (0.3 %). In a subgroup of 58 patients undergoing unprotected lef main PCI, provisional stenting was used in 88 %. DES penetration was 94 %. PCI was angiografcally successful in all patients. Hospital and 30-day mortality rates were 0 %, 1-year mortality 1.7 % (95 % confidence interval 0–11 %) and 5-year mortality 13.8 % (95 % confidence interval 7–33 %). Target vessel revascularization at 5 years was 3.5 % (95 % confidence interval 0–23 %).Conclusion: PCI in patients with predominantly stable coronary artery disease in the Medicor Cardiovascular Center appears to be an effective and safe method of revascularization, which is also true for an intervention in unprotected left main.

Abstract 4291: Left Atrial Appendage Occlusion: Early Clinical Results with a New Clip

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Sacha P Salzberg ◽  
Andre Plass ◽  
Hatem Alkadhi ◽  
Jurg Grunenfelder ◽  
Rolf Jenny ◽  
...  
Keyword(s):  
Left Atrial ◽  
Heart Surgery ◽  
Left Atrial Appendage ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Clinical Results ◽  
Atrial Appendage

Background: Atrial fibrillation (AF) is a common arrhythmia and as such a significant risk factor for stroke originating from the left atrial appendage (LAA). The purpose of this study is to evaluate surgical LAA occlusion with a new clip in patients with AF undergoing open heart surgery (OHS) at 3 month follow-up with cardiac multidetector computed tomography (MDCT). Patients and Methods: From 9/2007 to 5/2008, patients undergoing OHS with AF were enrolled in a trial for concomitant clip placement (LAA clip, Atricure Inc., Westchester, Ohio (USA)). The LAA clip is composed of titanium rods with nitinol hinges, surrounded by polyester braiding, applied epicardially on the LAA. LAA geometry and perfusion was assessed by trans-esophageal echocardiography (TEE). Postoperative and 3 month follow-up MDCT was compared to preoperative data to assess Clip location, LAA perfusion and cardiac anatomy. Results: 30 patients underwent LAA Clip placement through a median sternotomy. Clip deployment was successful in all (n=30), no device related complications occurred. LAA measurement and clip placement took less than 30 seconds and one attempt. After deployment TEE confirmed absence of LAA perfusion in all. Operative mortality was 6% (n=2) and was unrelated to clip placement. Pre-discharge (n=28) and 3 month follow-up (n=18) MDCT demonstrated stable clip location, absent LAA perfusion and normal surrounding cardiac structures. Conclusion: LAA Clip occlusionis safe, easy and straightforward. LAA occlusion remains effective and durable, per TEE and MDCT. When applied in a minimally invasive fashion LAA clip occlusion might offer a valuable tool for stroke prevention in selected patients.

scholarly journals Congenital left circumflex artery to left atrial appendage fistula: searching for a ‘colorful fountain’

2011 ◽  
Vol 12 (10) ◽  
pp. 805-805
Author(s):  
Ali Hamadanchi ◽  
Andreas Finkensieper ◽  
Marcus Franz ◽  
Bernhard R. Brehm ◽  
Hans R. Figulla
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Circumflex Artery ◽  
Left Circumflex Artery

scholarly journals Multi-modality imaging of a left atrial myxoma

2017 ◽  
Vol 5 ◽  
pp. 2050313X1773623 ◽  
Author(s):  
Hae Won Jung ◽  
Joon Hyung Doh ◽  
Woo-Ik Chang
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Atrial ◽  
Heart Surgery ◽  
Cardiac Computed Tomography ◽  
Invasive Coronary Angiography ◽  
Open Heart Surgery ◽  
Atrial Myxoma ◽  
Cardiac Computed Tomography Angiography ◽  
Left Atrial Myxoma

Objectives: Although echocardiography has traditionally been used to diagnose myxoma, invasive or non-invasive coronary angiography can be useful diagnostic tool before surgery. Methods: We present a case of an angiographically detected left atrial myxoma feeding from the left circumflex coronary artery. Results: The patient underwent open-heart surgery to remove the left atrial myxoma. After ligation of feeding artery, the mass was successfully excised Conclusion: Preoperative coronary angiography can offer additional valuable information moreover detecting coronary artery disease. Because, there is sudden death risk from embolization during invasive coronary angiography, preoperative cardiac computed tomography angiography should be considered to plan the surgery of myxoma.

scholarly journals A case report of a late left atrial appendage perforation 4 months after occluder implant: reason for or caused by a resuscitation?

2019 ◽  
Vol 3 (4) ◽  
pp. 1-4
Author(s):  
Karsten Schenke ◽  
Stephan Geidel ◽  
Christian Keller ◽  
Gerian Grönefeld
Keyword(s):  
Coronary Artery ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Pericardial Tamponade ◽  
Spontaneous Circulation ◽  
Atrial Appendage ◽  
Common Disease ◽  
Circumflex Artery ◽  
Serious Adverse Events ◽  
Occlusion Device

Abstract Background Atrial fibrillation (AF) is a common disease and can lead to cardioembolic stroke. Stroke prevention according to the CHA2DS2VASc score is achieved via oral anticoagulation. In recent years, interventional occlusion of the left atrial appendage (LAA) has become a common alternative. Besides showing non-inferiority in large trials compared with warfarin interventional LAA occlusion can lead to serious adverse events with most of them occurring peri-interventionally. Case summary A 75-year-old man with AF and recurrent gastrointestinal bleedings was referred for an interventional closure of the LAA. The intervention was successful with an ABBOTT® Amulet device. Four months later, the patient had to be resuscitated. Return of spontaneous circulation occurred after 10 min. On hospital arrival, echocardiography revealed a pericardial tamponade and 2 L of blood were drained. A coronary angiogram revealed a lesion with active leakage of contrast agent in the proximal circumflex artery. The patient was transferred to the cardiac surgery department immediately. Intra-operatively a perforation of the tissue at the basis of the LAA close to the left main coronary artery was discovered. The occluder was excised and the LAA was closed by endocardial sutures. Discussion In this report, we review the literature concerning interventional LAA occlusion and the reported cases of LAA perforation. Retrospectively, it remains unclear whether the perforation caused the resuscitation or was induced by it. To our knowledge, this is the first reported case of a laceration of a coronary artery by an occlusion device.

P9-05 Acquired coronary artery fistula after open heart surgery for congenital heart disease

2004 ◽  
Vol 97 ◽  
pp. S64-S65
Author(s):  
Shuenn-Nan Chiu ◽  
Mei-Hwan Wu ◽  
Ming-Tai Lin ◽  
En-Ting Wu ◽  
Jou-Kou Wang ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Coronary Artery Fistula ◽  
Open Heart
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