Left Atrial Appendage
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2021 ◽  
Vol 71 ◽  
pp. 102905
Ibtissam Kissami ◽  
Ghizlane El Ouazzani ◽  
Mehdi El Bekkaoui ◽  
Imane Skiker ◽  
Nouha Elouafi ◽  

Giuseppe D´Ancona ◽  
Erdal Safak ◽  
Denise Weber ◽  
Fatih Arslan ◽  
Stephan Kische ◽  

2021 ◽  
Vol 8 ◽  
Bin-Feng Mo ◽  
Rui Zhang ◽  
Jia-Li Yuan ◽  
Jian Sun ◽  
Peng-Pai Zhang ◽  

Background: The aim of this study was to investigate the efficacy of left atrial appendage closure (LAAC) for primary and secondary stroke prevention in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF).Methods: This pilot study enrolled 36 patients with HCM and AF who underwent LAAC between April 2017 and December 2019, of whom 22 were for primary stroke prevention and 14 were for secondary prevention.Results: The patients enrolled in this study had non-obstructive (86.1%) or mild obstructive (13.9%) HCM. Patients in the Secondary Prevention Group had higher CHA2DS2-VASc scores (5.1 ± 1.4 vs. 2.6 ± 1.6, P < 0.001) and higher HAS-BLED scores (2.8 ± 1.0 vs. 1.5 ± 0.9, P < 0.001) compared with those in the Primary Prevention Group. Successful closure with satisfactory seals (residual leak ≤ 5 mm) was achieved in all patients, with complete occlusion in 86.4% of the Primary Prevention Group and 92.9% of the Secondary Prevention Group. Procedural-related complications included one pericardial effusion and one groin hematoma. One device-related thrombus was identified in the Secondary Prevention Group and resolved after anticoagulation. During a mean follow-up time of 28.4 months, one bleeding event was recorded. There were no thromboembolic events or deaths in either group, with 97.2% of the patients achieving freedom from anticoagulation therapy.Conclusions: Initial results suggest that LAAC can be a safe and feasible alternative for primary and secondary stroke prevention in selected patients with HCM and AF. Further studies with larger samples are required.

Cureus ◽  
2021 ◽  
Rajat Jain ◽  
Puneet Aggarwal ◽  
Mukesh J Jha ◽  
Bhagya Narayan Pandit ◽  
Preeti Gupta ◽  

Circulation ◽  
2021 ◽  
Vol 144 (14) ◽  
pp. 1088-1090
Subodh Verma ◽  
Deepak L. Bhatt ◽  
Elaine E. Tseng

G. D'Ancona ◽  
H. Ince

2021 ◽  
Vol 8 ◽  
Xiaoyan Wang ◽  
Xueying Chen ◽  
Yong Ye ◽  
Juan Peng ◽  
Jinyi Lin ◽  

Background: Cardiac troponin T (cTNT) has been widely used in detecting cardiac damage. Elevated cTNT level has been reported to be associated with increased mortality in multiple cardiac conditions. It is not uncommon to observe an increased level of cTNT in patients after left atrial appendage occlusion (LAAO). The objective of the study is to study the incidence, significance, and factors associated with cTNT elevation after LAAO.Methods: We prospectively included patients who underwent LAAO from January 2019 to July 2020 in Fudan Zhongshan Hospital. Patients were divided into those with elevated cTNT after procedure and those with normal postprocedure cTNT. All individuals were followed up for 1 year. The primary outcome is major adverse cardiovascular events, which include myocardial infarction, heart failure, cardiac death, and stroke. The second outcome is periprocedure complication, including chest pain, tachycardia, cardiac tamponade, change of electrocardiograph, and atrial thrombus.Results: A total of 190 patients were enrolled. Of the patients, 85.3% had elevated cTNT after LAAO, while 14.7% of them did not. Exposure time, dosage of contrast, types of devices, shapes, and sizes of LAA could contribute to elevated postprocedure cTNT. We found that patients with a Watchman device were more likely to have elevated postprocedure cTNT than those with a Lambre device (89.2 vs. 76.7%, p = 0.029). LAAO shapes were associated with cTNT levels in patients with a Watchman device, while the diameter of the outer disc and LAA depth mattered for the Lambre device. There was no significant difference in the primary and second outcome between the two groups (p-value: 0.619, 0.674).Conclusion: LAAO was found to be commonly accompanied with cTNT elevation, which might not to be related to the complications and adverse cardiac outcomes within 1 year of follow-up. Moreover, eGFR at baseline, exposure time, dosage of contrast, types of LAAO device, and LAA morphology could contribute to cTNT elevation.

2021 ◽  
Vol 14 (19) ◽  
pp. 2191-2193
Jacqueline Saw ◽  
Nils Perrin ◽  
Thomas Nestelberger ◽  
Blandine Mondésert ◽  
Michael Tsang ◽  

2021 ◽  
K Millar ◽  
R Gallen ◽  
Y Goh ◽  
H Muradagha ◽  
M McKittrick ◽  

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