BACKGROUND: The interventional left atrial appendage (LAA) closure represents an emerging alternative to oral anticoagulation for stroke prevention in certain atrial fibrillation patients. Preliminary results have suggested high procedural success rates and fewer peri-interventional complications; however, there persists an insufficient understanding of the role of many underlying confounding variables (e.g., anatomical characteristics). HYPOTHESIS: It was investigated whether varying LAA morphologies influence procedural success as well as in-hospital outcome. METHODS: Sixty-seven patients ineligible for long-term oral anticoagulation were included in this single-center, prospective, observational registry spanning from the years 2014 to 2016. Interventions were performed with the Watchman occluder (Boston Scientific, Natick, MA) or the Amplatzer Amulet (St. Jude Medical, St. Paul, MN), at the operator's discretion. Results derived from the data describing procedural success, fluoroscopy, and peri-interventional safety events were classified according to the presenting LAA morphology (cauliflower, cactus, windsock, and chicken wing). RESULTS: Rates of successful implantation were high across all groups (≥98%; P = 0.326). Surrogate parameters underlining procedural complexity like median total duration (P = 0.415), median fluoroscopy time (P = 0.459), median dose area product (P = 0.698), and the median amount of contrast agent (P = 0.076) demonstrated similar results across all groups. Likewise, the periprocedural complication rate was not significantly different and was mainly restricted to minor bleeding events. CONCLUSIONS: Irrespective of the varying morphological presentation of the LAA, the procedural success rates, interventional characteristics, and safety events did not significantly differ among patients receiving an interventional LAA closure.
BACKGROUND: The interventional left atrial appendage (LAA) closure represents an emerging alternative to oral anticoagulation for stroke prevention in certain atrial fibrillationpatients. Preliminary results have suggested high procedural success rates and fewer peri-interventional complications; however, there persists an insufficient understanding of the role of many underlying confounding variables (e.g., anatomical characteristics). HYPOTHESIS: It was investigated whether varying LAA morphologies influence procedural success as well as in-hospital outcome. METHODS: Sixty-seven patients ineligible for long-term oral anticoagulation were included in this single-center, prospective, observational registry spanning from the years 2014 to 2016. Interventions were performed with the Watchman occluder (Boston Scientific, Natick, MA) or the Amplatzer Amulet (St. Jude Medical, St. Paul, MN), at the operator's discretion. Results derived from the data describing procedural success, fluoroscopy, and peri-interventional safety events were classified according to the presenting LAA morphology (cauliflower, cactus, windsock, and chicken wing). RESULTS: Rates of successful implantation were high across all groups (≥98%; P = 0.326). Surrogate parameters underlining procedural complexity like median total duration (P = 0.415), median fluoroscopy time (P = 0.459), median dose area product (P = 0.698), and the median amount of contrast agent (P = 0.076) demonstrated similar results across all groups. Likewise, the periprocedural complication rate was not significantly different and was mainly restricted to minor bleeding events. CONCLUSIONS: Irrespective of the varying morphological presentation of the LAA, the procedural success rates, interventional characteristics, and safety events did not significantly differ among patients receiving an interventional LAA closure.
Authors: Christian Fastner; Michael Behnes; Benjamin Sartorius; Annika Wenke; Ibrahim El-Battrawy; Uzair Ansari; Ishar-Singh Gill; Martin Borggrefe; Ibrahim Akin Journal: Clin Cardiol Date: 2017-04-13 Impact factor: 2.882
Authors: Christian Fastner; Ralf Lehmann; Michael Behnes; Benjamin Sartorius; Martin Borggrefe; Ibrahim Akin Journal: Cardiovasc Revasc Med Date: 2016-01-22
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Authors: Marina Urena; Josep Rodés-Cabau; Xavier Freixa; Jacqueline Saw; John G Webb; Mélanie Freeman; Eric Horlick; Mark Osten; Albert Chan; Jean-Francois Marquis; Jean Champagne; Réda Ibrahim Journal: J Am Coll Cardiol Date: 2013-05-09 Impact factor: 24.094
Authors: Christian Fastner; Michael Behnes; Benjamin Sartorius; Annika Wenke; Ibrahim El-Battrawy; Uzair Ansari; Ishar-Singh Gill; Martin Borggrefe; Ibrahim Akin Journal: Clin Cardiol Date: 2017-04-13 Impact factor: 2.882
Authors: Simon Lindner; Michael Behnes; Annika Wenke; Benjamin Sartorius; Wulf Dieker; Uzair Ansari; Muharrem Akin; Thomas Bertsch; Kambis Mashayekhi; Nils Vogler; Holger Haubenreisser; Stefan O Schoenberg; Martin Borggrefe; Ibrahim Akin Journal: Clin Cardiol Date: 2018-12-21 Impact factor: 2.882