التفاصيل البيبلوغرافية
العنوان:
Cardiac CT and echocardiographic evaluation of peri-device flow after percutaneous left atrial appendage closure using the AMPLATZER cardiac plug device
المؤلفون:
Gilbert Puippe , Ulf Landmesser , Andreas R. Luft , Thomas F. Lüscher , Sacha P. Salzberg , Milosz Jaguszewski , Maja Müller , Volkmar Falk , Costantina Manes , Hatem Alkadhi
المصدر:
Catheterization and Cardiovascular Interventions . 85:306-312
بيانات النشر:
Wiley, 2014.
سنة النشر:
2014
مصطلحات موضوعية:
medicine.medical_specialty , Percutaneous , business.industry , Peri , Atrial fibrillation , General Medicine , medicine.disease , Lobe , Catheter , medicine.anatomical_structure , Left atrial , Internal medicine , medicine , Cardiology , Radiology, Nuclear Medicine and imaging , Clinical significance , Cardiology and Cardiovascular Medicine , business , Stroke
الوصف:
Objectives: The aim of the study was to examine frequency, size and localization of peri-device leaks after percutaneous left atrial appendage(LAA)-closure with the AMPLATZER-Cardiac-Plug (ACP) by using a multimodal imaging approach, i.e. combined cardiac-CT and TEE follow-up. Background: Catheter-based LAA-occlusion using ACP aims to reduce the risk of stroke in patients with atrial fibrillation. Detection of peri-device leaks after ACP implantation by TEE is challenging, the few available data are inconsistent and the frequency of LAA leaks after ACP implantation remains therefore unclear. Methods: Cardiac-CT using a multi-phase protocol and a second-generation dual-source-CT-system was performed in twenty-four patients with non-valvular atrial fibrillation starting 3 months after LAA-closure by ACP. Color Doppler multiplane TEE was used to evaluate peri-device flow. Results: Cardiac-CT follow-up detected any persistent LAA contrast filling in 62% of patients (n=15), but leak-sizes were small (1.5±1.4mm). Peri-device leaks were almost exclusively localized at the posterior portion of the LAA-orifice (>90%). TEE follow-up revealed peri-device flow in 36% of patients (jet-sizes:≤4mm). ACP-lobe compression (>10 %) and perpendicular ACP-lobe orientation to the LAA-neck axis, that was also dependent on LAA anatomy, were substantially more frequent in patients with complete LAA closure. Conclusion: The present study evaluates for the first time peri-device flow after LAA closure by ACP using a combined cardiac-CT and TEE follow-up. Persistent LAA-perfusion was frequently detected, leak-sizes were small and were less frequent when lobe compression was >10% and lobe orientation was perpendicular to the LAA-neck axis, that was also related to the LAA anatomy. The clinical significance of these small leaks after LAA-closure using ACP needs to be further evaluated in future studies. © 2014 Wiley Periodicals, Inc.
تدمد:
1522-1946
URL الوصول:
https://explore.openaire.eu/search/publication?articleId=doi_________::5caac6429e873db998591f8d75a5320e https://doi.org/10.1002/ccd.25667
حقوق:
CLOSED
رقم الأكسشن:
edsair.doi...........5caac6429e873db998591f8d75a5320e
قاعدة البيانات:
OpenAIRE