دورية أكاديمية
أعرض في EDS

Clinical outcomes of patients undergoing percutaneous left atrial appendage occlusion in general anaesthesia or conscious sedation: data from the prospective global Amplatzer Amulet Occluder Observational Study.

التفاصيل البيبلوغرافية
العنوان: Clinical outcomes of patients undergoing percutaneous left atrial appendage occlusion in general anaesthesia or conscious sedation: data from the prospective global Amplatzer Amulet Occluder Observational Study.
المؤلفون: Piayda K; Department of Cardiology, Pneumology and Vascular Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Nordrhein-Westfalen, Germany., Hellhammer K; Department of Cardiology, Pneumology and Vascular Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Nordrhein-Westfalen, Germany., Nielsen-Kudsk JE; Department of Cardiology, Aarhus University, Aarhus, Denmark., Schmidt B; Department of Cardiology, Bethanien-Krankenhaus, Frankfurt am Main, Hessen, Germany., Mazzone P; Department of Cardiology, Ospedale San Raffaele, Milano, Italy., Berti S; Department of Cardiology, Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanita Pubblica, Pisa, Toscana, Italy., Fischer S; Department of Cardiology, Harzklinikum Dorothea Christiane Erxleben GmbH, Quedlinburg, Sachsen-Anhalt, Germany., Lund J; Department of Cardiology, Turku University Hospital, Turku, Finland., Montorfano M; Department of Interventional Cardiology, Istituto Scientifico Universitario San Raffaele, Milano, Lombardia, Italy., Della Bella P; Department of Arrhythmology, San Raffaele Hospital, Milano, Lombardia, Italy., Gage R; Structural Heart, Abbott Cardiovascular-St Paul, Saint Paul, Minnesota, USA., Zeus T; Department of Cardiology, Pneumology and Vascular Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Nordrhein-Westfalen, Germany Zeus@med.uni-duesseldorf.de.
المصدر: BMJ open [BMJ Open] 2021 Mar 24; Vol. 11 (3), pp. e040455. Date of Electronic Publication: 2021 Mar 24.
نوع المنشور: Journal Article; Multicenter Study; Observational Study
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Atrial Appendage*/diagnostic imaging , Atrial Appendage*/surgery , Atrial Fibrillation*/therapy , Stroke*, Aged ; Anesthesia, General ; Cardiac Catheterization/adverse effects ; Conscious Sedation ; Humans ; Prospective Studies ; Treatment Outcome
مستخلص: Objective: To evaluate the safety and efficacy of percutaneous left atrial appendage occlusion (LAAO) using conscious sedation (CS).
Background: Several percutaneous structural heart disease interventions are safely and efficiently performed using CS instead of general anaesthesia (GA). This concept has not been evaluated in a large multicenter cohort of patients undergoing LAAO.
Methods: Patients from the prospective, global Amplatzer Amulet Occluder Observational Study were divided into two groups (GA vs CS). Baseline information, periprocedural and postprocedural efficacy and complications, as well as outcomes through 7 days post implant were compared.
Results: Patients undergoing transesophageal-guided implants were categorised by GA (n=607, 64%) or CS (n=342, 36%) usage. Mean age was 75 years in both groups. LAAO technical success was achieved in 99% of both groups. The procedure duration (GA: 35±22 min vs CS: 27±19 min, p<0.001), total amount of contrast medium (GA: 105±81 mL vs CS: 86±66 mL, p<0.001) and fluoroscopic time (GA: 13±9 min vs CS: 12±13 min, p<0.001) were less in CS cases. Procedure-related or device-related serious adverse events during the first 7 days were numerically higher in the CS group (GA: 4.9% vs CS: 7.6%, p=0.114). Peridevice residual flow was absent or ≤5 mm 1-3 months after the procedure in 99.7% of the GA and in 100% of the CS group (p=1.000).
Conclusions: In a large global study, LAAO with the Amplatzer Amulet occluder is safe and feasible using CS. Procedure duration and total amount of contrast were less with CS than GA cases.
Trial Registration Number: NCT02447081; Results.
Competing Interests: Competing interests: Dr Nielsen-Kudsk has served as a proctor for Abbott and is a consultant for Abbott and Boston Scientific. Dr Schmidt has served as a consultant for Boston Scientific and Medtronic. Dr Mazzone has served as a consultant for Abbott, Boston Scientific, and Medtronic. Dr Berti has served as a proctor for Abbott. Dr Fischer has served as a proctor for Biotronik and Boston Scientific and is a consultant for Abbott. Dr Lund has served as a proctor for Abbott. Dr Montorfano has served as a proctor for Abbott, Boston Scientific, and Edwards Lifesciences. Dr Della Bella has served as a proctor and consultant for Abbott. Mr Gage is an employee of Abbott and was involved in data review and analysis. Dr Zeus has received consulting fees, travel expenses or study honorariums from Medtronic and Edwards Lifesciences outside of this work. All other authors have nothing to disclose with regard to this project.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
References: Int J Cardiol. 2014 Dec 15;177(2):448-54. (PMID: 25443245)
Curr Opin Anaesthesiol. 2019 Dec;32(6):769-775. (PMID: 31389805)
Circ Arrhythm Electrophysiol. 2016 Jun;9(6):. (PMID: 27307517)
JACC Cardiovasc Interv. 2019 Jun 10;12(11):1091-1093. (PMID: 31171287)
JACC Cardiovasc Imaging. 2017 Aug;10(8):938-952. (PMID: 28797417)
Eur Heart J. 2016 Oct 7;37(38):2893-2962. (PMID: 27567408)
Circulation. 2014 Feb 25;129(8):837-47. (PMID: 24345399)
Catheter Cardiovasc Interv. 2014 Oct 1;84(4):E38-42. (PMID: 24909413)
Circulation. 2017 Nov 28;136(22):2132-2140. (PMID: 28864443)
Eur Heart J Suppl. 2017 May;19(Suppl D):D333-D353. (PMID: 28751849)
Reg Anesth Pain Med. 2014 Mar-Apr;39(2):112-9. (PMID: 24509423)
EuroIntervention. 2018 Jun 20;14(2):151-157. (PMID: 29508766)
J Interv Cardiol. 2013 Oct;26(5):509-14. (PMID: 24033805)
Ann Intern Med. 2017 Mar 7;166(5):ITC33-ITC48. (PMID: 28265666)
Asian Cardiovasc Thorac Ann. 2015 May;23(4):394-8. (PMID: 25178469)
Curr Cardiol Rep. 2017 Sep 6;19(10):102. (PMID: 28879526)
JAMA Cardiol. 2017 May 1;2(5):525-534. (PMID: 28355434)
J Interv Cardiol. 2017 Apr;30(2):163-169. (PMID: 28256020)
Circulation. 2011 Feb 1;123(4):417-24. (PMID: 21242484)
Heart Rhythm. 2019 Aug;16(8):e66-e93. (PMID: 30703530)
EuroIntervention. 2017 Sep 20;13(7):867-876. (PMID: 28649053)
Heart. 2014 May;100(9):691-5. (PMID: 24459291)
JAMA. 2014 Nov 19;312(19):1988-98. (PMID: 25399274)
Catheter Cardiovasc Interv. 2018 Feb 15;91(3):540-547. (PMID: 28862376)
Cureus. 2019 Jun 3;11(6):e4812. (PMID: 31281765)
JACC Cardiovasc Interv. 2019 Jan 14;12(1):90-97. (PMID: 30553706)
Neth Heart J. 2017 Dec;25(12):669-674. (PMID: 28887807)
J Am Heart Assoc. 2019 Jul 2;8(13):e011577. (PMID: 31230500)
Heart. 2018 Oct;104(19):1621-1628. (PMID: 29599379)
JAMA Cardiol. 2017 Dec 1;2(12):1369-1374. (PMID: 29049467)
فهرسة مساهمة: Keywords: cardiology; stroke medicine; thromboembolism
سلسلة جزيئية: ClinicalTrials.gov NCT02447081
تواريخ الأحداث: Date Created: 20210325 Date Completed: 20210519 Latest Revision: 20210519
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7993182
DOI: 10.1136/bmjopen-2020-040455
PMID: 33762228
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2020-040455