scholarly journals Management of Residual Left Atrial Appendage Stump with a Second Epicardial Clip.

2021 ◽  
Author(s):  
Saqib Masroor ◽  
Abdullah Nasif
Keyword(s):  
Success Rate ◽  
Risk Reduction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Significant Complication

Epicardial exclusion of LAA has gained increasing popularity since its introduction in 2009. While the clip has demonstrated a success rate ranging from 93.9-100% in excluding the LAA, one significant complication is incomplete exclusion due to residual stump (> 1 cm) as a result of the clip being deployed too distally. We describe here the first reported case of implanting a second clip underneath the first clip to obliterate the residual stump for a 71-year-old male with AF evaluated for intervention for stroke risk reduction.

scholarly journals Novel stroke risk reduction in atrial fibrillation: left atrial appendage occlusion with a focus on the Watchman closure device

2017 ◽  
Vol Volume 13 ◽  
pp. 81-90 ◽  
Author(s):  
Arash Alipour ◽  
Lisette I S Wintgens ◽  
Martin J Swaans ◽  
Jippe C Balt ◽  
Benno JWM Rensing ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Closure Device ◽  
Left Atrial Appendage Occlusion

scholarly journals Long term outcomes after left atrial appendage closure with the LARIAT device—Stroke risk reduction over five years follow-up

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208710 ◽  
Author(s):  
Radoslaw Litwinowicz ◽  
Magdalena Bartus ◽  
Marian Burysz ◽  
Maciej Brzeziński ◽  
Piotr Suwalski ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Long Term Outcomes ◽  
Left Atrial Appendage Closure

Abstract 16185: Medicare Budget Implications of Left Atrial Appendage Closure for Stroke Risk Reduction in Non-Valvular Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Shannon O Armstrong ◽  
Stacey L Amorosi ◽  
Susan S Garfield ◽  
Ken Stein
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Clinical Outcomes ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Budget Impact ◽  
Atrial Appendage ◽  
Medicare Beneficiaries ◽  
Left Atrial Appendage Closure

Introduction: Strokes associated with atrial fibrillation (AF) are estimated to cost Medicare $8 billion annually. Advancements in stroke prevention are aimed at improving clinical outcomes and reducing healthcare costs. This analysis quantifies the budget impact to Medicare and Medicare beneficiaries of left atrial appendage closure (LAAC) with the Watchman Device compared to warfarin, the standard of care, and rivaroxaban, the most commonly prescribed new oral anticoagulant in the US, for stroke risk reduction in non-valvular AF. Methods: A budget impact model was developed from a Medicare perspective using 2.3-year data from PROTECT AF and relative risks from ROCKET AF. The model captured all costs of treatment and associated complications. Costs for stroke included acute, direct costs as well as long-term disability costs. Cost data were from 2014 US DRGs. Medicare deductibles and co-insurance rates were used in the patient analysis. Results: In addition to better net clinical outcomes (table), LAAC is cost neutral to Medicare relative to warfarin and rivaroxaban by year 5, and one third less costly than both by year 10. Treatment-related complications comprised 33% of LAAC total costs compared to 65% for rivaroxaban and 87% for warfarin at year 5. Patient out-of-pocket costs for LAAC were lower than warfarin and rivaroxaban at 2 and 3 years, respectively. Conclusions: Upfront LAAC procedural costs are offset by ongoing therapy and complication costs associated with warfarin and rivaroxaban. LAAC with Watchman represents an opportunity for improved clinical outcomes and substantial savings to both Medicare and Medicare beneficiaries.

scholarly journals Thoracoscopic extracardiac obliteration of the left atrial appendage for stroke risk reduction in atrial fibrillation

2003 ◽  
Vol 42 (7) ◽  
pp. 1249-1252 ◽  
Author(s):  
Joseph L Blackshear ◽  
W.Dudley Johnson ◽  
John A Odell ◽  
Vickie S Baker ◽  
Mary Howard ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage

Stroke Prophylaxis by Percutaneous Closure of Patent Foramen Ovale and Left Atrial Appendage

2011 ◽  
Vol 6 (1) ◽  
pp. 67
Author(s):  
Antonio L Bartorelli ◽  
Claudio Tondo ◽  
◽  
Keyword(s):  
Left Atrial ◽  
Patent Foramen Ovale ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Cryptogenic Stroke ◽  
Atrial Appendage ◽  
Foramen Ovale ◽  
Percutaneous Procedures ◽  
Cerebrovascular Events

Innovative percutaneous procedures for stroke prevention have emerged in the last two decades. Transcatheter closure of the patent foramen ovale (PFO) is performed in patients who suffered a cryptogenic stroke or a transient ischaemic attach (TIA) in order to prevent recurrence of thromboembolic events. Percutaneous occlusion of the left atrial appendage (LAA) has been introduced to reduce stroke risk in patients with atrial fibrillation (AF). The role of PFO and LAA in the occurrence of cerebrovascular events and the interventional device-based therapies to occlude the PFO and LAA are discussed.

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