دورية أكاديمية
Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A systematic review.
| العنوان: | Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A systematic review. |
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| المؤلفون: | Helal B; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Khan J; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., AlJayar D; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Khan MS; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Alabdaljabar MS; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Asad ZUA; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA., DeSimone CV; Department of Cardiovascular Medicine, 200 1St Street SW, Rochester, MN, 55905, USA., Deshmukh A; Department of Cardiovascular Medicine, 200 1St Street SW, Rochester, MN, 55905, USA. Deshmukh.Abhishek@mayo.edu. |
| المصدر: | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2024 Jun; Vol. 67 (4), pp. 865-885. Date of Electronic Publication: 2024 Jan 06. |
| نوع المنشور: | Systematic Review; Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Netherlands NLM ID: 9708966 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-8595 (Electronic) Linking ISSN: 1383875X NLM ISO Abbreviation: J Interv Card Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : Springer Original Publication: Norwell, MA : Kluwer Academic Publishers, c1997- |
| مواضيع طبية MeSH: | Atrial Appendage*/surgery , Atrial Appendage*/diagnostic imaging , Atrial Fibrillation*/surgery, Humans ; Risk Factors ; Postoperative Complications/prevention & control ; Septal Occluder Device ; Female ; Stroke/prevention & control ; Stroke/etiology ; Male ; Left Atrial Appendage Closure |
| مستخلص: | Background: Left atrial appendage closure (LAAC) is a treatment modality for stroke prevention in patients with atrial fibrillation (AF). One of the potential complications of LAAC is a peri-device leak (PDL), which could potentially increase the risk of thromboembolism formation. Methods: This systematic review was done according to PRISMA guidelines. Using four databases, all primary studies through April 2022 that met selection criteria were included. Outcomes of interest were studies reporting on PDL characteristics, risk factors and management. Results: A total of 116 studies met selection criteria (97 original studies and 19 case reports/series). In the original studies (n = 30,133 patients), the weighted mean age was 72.0 ± 7.4 years (57% females) with a HAS-BLED and CHA2DS2-VASc weighted means of 2.8 ± 1.1 and 3.8 ± 1.3, respectively. The most common definition of PDL was based on size; 5 mm: major, 3-5 mm: moderate, < 1 mm minor, or trivial. Follow up time for PDL detection was 7.15 ± 9.0 months. 33% had PDL, irrespective of PDL severity/size, and only 0.9% had PDL of greater than 5 mm. The main risk factors for PDL development included lower degree of over-sizing, lower left ventricular ejection fraction, device/LAA shape mismatch, previous radiofrequency ablation, and male sex. The most common methods to screen for PDL included transesophageal echocardiogram and cardiac CT. PDL Management approaches include Amplatzer Patent Foramen Ovale occluder, Hookless ACP, Amplatzer vascular plug II, embolic coils, and detachable vascular coils; removal or replacement of the device; and left atriotomy. Conclusion: Following LAAC, the emergence of a PDL is a significant complication to be aware of. Current evidence suggests possible risk factors that are worth assessing in-depth. Additional research is required to assess suitable candidates, timing, and strategies to managing patients with PDL. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Atrial fibrillation; Left atrial appendage; Peri-device leak; Watchman |
| تواريخ الأحداث: | Date Created: 20240105 Date Completed: 20240611 Latest Revision: 20240627 |
| رمز التحديث: | 20240627 |
| DOI: | 10.1007/s10840-023-01729-z |
| PMID: | 38182966 |
| قاعدة البيانات: | MEDLINE |
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| DOI: | 10.1007/s10840-023-01729-z |