Jai-Wun Park1, Horst Sievert2, Caroline Kleinecke3, Laura Vaskelyte4, Steffen Schnupp3, Kolja Sievert4, Yat-Yin Lam5, Barbara E Stähli6, Deyuan Zhang7, Anning Li7, Johannes Brachmann8. 1. Medical Clinic II (Cardiology/Intensive Care Medicine), Klinikum Coburg, Coburg, Germany; Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin, Germany. 2. CardioVascular Center Frankfurt (CVC), Frankfurt, Germany; Anglia Ruskin University, Chelmsford, UK. 3. Medical Clinic II (Cardiology/Intensive Care Medicine), Klinikum Coburg, Coburg, Germany. 4. CardioVascular Center Frankfurt (CVC), Frankfurt, Germany. 5. Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong. 6. Department of Cardiology, Charité Berlin - University Medicine, Campus Benjamin Franklin, Berlin, Germany. 7. LifeTech Scientific Corporation, Shenzen, China. 8. Medical Clinic II (Cardiology/Intensive Care Medicine), Klinikum Coburg, Coburg, Germany. Electronic address: brachmann.laptop@extern.klinikum-coburg.de.
Abstract
BACKGROUND: We here report the first European experience with the novel LAmbre left atrial appendage (LAA) occluder, a self-expanding device consisting of an umbrella and a cover connected by a central waist. METHODS AND RESULTS: A total of 60 patients (74.4 ± 8.3 years; 66.7% men; CHA2DS2-VASc: 4.0 ± 1.6, HAS-BLED score: 3.2 ± 1.3) with atrial fibrillation and contraindications to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the LAmbre device at two German centers between November 2013 and September 2015. Device success defined as correct placement of the device was achieved in all patients (100%). Resizing of the device was necessary in 3 (5%) patients. Device-related complications included 2 (3.3%) pericardial effusions on day 8 and 33 after the index procedure requiring pericardiocentesis. Transesophageal echocardiography at 6 months showed complete sealing of the LAA (residual jet flow of <5 mm) in 51/54 (94.4%) patients. No device-related thrombus was documented. At 12 months transient ischemic attack was observed in 1 patient (1.6%) and minor bleeding in 3 patients (5%). CONCLUSIONS: Although minimizing procedure-related complications remains challenging, LAAO with the LAmbre showed high device success and good mid-term performance regarding prevention of stroke and bleeding.
BACKGROUND: We here report the first European experience with the novel LAmbre left atrial appendage (LAA) occluder, a self-expanding device consisting of an umbrella and a cover connected by a central waist. METHODS AND RESULTS: A total of 60 patients (74.4 ± 8.3 years; 66.7% men; CHA2DS2-VASc: 4.0 ± 1.6, HAS-BLED score: 3.2 ± 1.3) with atrial fibrillation and contraindications to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the LAmbre device at two German centers between November 2013 and September 2015. Device success defined as correct placement of the device was achieved in all patients (100%). Resizing of the device was necessary in 3 (5%) patients. Device-related complications included 2 (3.3%) pericardial effusions on day 8 and 33 after the index procedure requiring pericardiocentesis. Transesophageal echocardiography at 6 months showed complete sealing of the LAA (residual jet flow of <5 mm) in 51/54 (94.4%) patients. No device-related thrombus was documented. At 12 months transient ischemic attack was observed in 1 patient (1.6%) and minor bleeding in 3 patients (5%). CONCLUSIONS: Although minimizing procedure-related complications remains challenging, LAAO with the LAmbre showed high device success and good mid-term performance regarding prevention of stroke and bleeding.
Authors: Muhammad Ali; Angelos G Rigopoulos; Mammad Mammadov; Abdelrahman Torky; Andrea Auer; Marios Matiakis; Elena Abate; Constantinos Bakogiannis; Stergios Tzikas; Boris Bigalke; Daniel Sedding; Michel Noutsias Journal: BMC Cardiovasc Disord Date: 2020-02-12 Impact factor: 2.298