Xavier Freixa1, Ali Abualsaud2, Jason Chan2, Mohamed Nosair2, Apostolos Tzikas3, Patrick Garceau2, Arsène Basmadjian2, Réda Ibrahim4. 1. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada; Department of Cardiology, Thorax Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. 2. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. 3. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada; Interbalkan European Medical Center, Thessaloniki, Greece. 4. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address: reda.ibrahim@icm-mhi.org.
Abstract
BACKGROUND: The Amplatzer™ Amulet™ (Amulet) is the evolution of the Amplatzer™ Cardiac Plug, a dedicated device for percutaneous left atrial appendage (LAA) occlusion. The new device has been designed to facilitate the implantation process, improve the sealing performance and further reduce the risk of complications. The objective of the study was to describe the initial experience with the Amplatzer Amulet for percutaneous LAA occlusion. METHODS: This was a prospective single-center study of patients undergoing percutaneous LAA occlusion. The indication for LAA closure was a formal contraindication for oral anticoagulation or previous history of stroke due to INR lability. All procedures were done under general anesthesia and transesophageal echocardiography (TEE) guidance. Transthoracic echocardiography was performed 24h after the procedure in order to rule out procedural complications before discharge. Further follow-up was done with a clinical visit and TEE at 1-3 months. RESULTS: Between July-2012 and June-2013, 25 patients with a mean CHA2DS2-VASC of 4.3 ± 1.7 underwent LAA occlusion with the Amplatzer Amulet. The device was successfully implanted in 24 patients (96%) without any procedural stroke, pericardial effusion or device embolization. None of the patients presented any clinical event at follow-up. Follow-up TEE showed complete LAA sealing in all patients with no residual leaks >3mm and no device embolization. One patient (4.1%) presented a device thrombosis at follow-up without clinical expression. CONCLUSION: In this initial series of patients, the Amulet showed a remarkable acute and short-term performance in terms of feasibility and safety as depicted by the high successful implantation rate and the low incidence of complications.
BACKGROUND: The Amplatzer™ Amulet™ (Amulet) is the evolution of the Amplatzer™ Cardiac Plug, a dedicated device for percutaneous left atrial appendage (LAA) occlusion. The new device has been designed to facilitate the implantation process, improve the sealing performance and further reduce the risk of complications. The objective of the study was to describe the initial experience with the Amplatzer Amulet for percutaneous LAA occlusion. METHODS: This was a prospective single-center study of patients undergoing percutaneous LAA occlusion. The indication for LAA closure was a formal contraindication for oral anticoagulation or previous history of stroke due to INR lability. All procedures were done under general anesthesia and transesophageal echocardiography (TEE) guidance. Transthoracic echocardiography was performed 24h after the procedure in order to rule out procedural complications before discharge. Further follow-up was done with a clinical visit and TEE at 1-3 months. RESULTS: Between July-2012 and June-2013, 25 patients with a mean CHA2DS2-VASC of 4.3 ± 1.7 underwent LAA occlusion with the Amplatzer Amulet. The device was successfully implanted in 24 patients (96%) without any procedural stroke, pericardial effusion or device embolization. None of the patients presented any clinical event at follow-up. Follow-up TEE showed complete LAA sealing in all patients with no residual leaks >3mm and no device embolization. One patient (4.1%) presented a device thrombosis at follow-up without clinical expression. CONCLUSION: In this initial series of patients, the Amulet showed a remarkable acute and short-term performance in terms of feasibility and safety as depicted by the high successful implantation rate and the low incidence of complications.
Authors: David Altszuler; Alan F Vainrib; Daniel G Bamira; Ricardo J Benenstein; Anthony Aizer; Larry A Chinitz; Muhamed Saric Journal: Curr Cardiol Rep Date: 2019-06-10 Impact factor: 2.931
Authors: Etem Caliskan; James L Cox; David R Holmes; Bernhard Meier; Dhanunjaya R Lakkireddy; Volkmar Falk; Sacha P Salzberg; Maximilian Y Emmert Journal: Nat Rev Cardiol Date: 2017-08-10 Impact factor: 32.419