Ghulam Murtaza1, Mohit K Turagam2, Tawseef Dar3, Krishna Akella1, Bharath Yarlagadda4, Steffen Gloekler5, Bernhard Meier5, Jacqueline Saw6, Jung-Sun Kim7, Hong-Euy Lim8, Nietlispach Fabian9, James Gabriels10, Lucas V Boersmaj11, Martin J Swaans11, Mohmad Tantary12, Sibghat Tul Llah13, Apostolos Tzikas14, Rakesh Gopinathannair1, Dhanunjaya Lakkireddy1. 1. Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, Kansas. 2. Department of Cardiology, Garden City Hospital, Garden City, Michigan. 3. Massachusetts General Hospital, Boston, Massachusetts. 4. Division of Cardiology, University of New Mexico. 5. Department of Cardiology, University Hospital of Bern, Bern, Switzerland. 6. Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 7. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. 8. Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. 9. University Heart Center, University Hospital Zurich, Zurich, Switzerland. 10. Department of Cardiology, Northwell Health, North Shore University Hospital, NY, USA. 11. Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. 12. Clinch Valley Medical Center, Virginia, USA. 13. Saint Joseph hospital and Medical Center, Phoenix, Arizona. 14. AHEPA University Hospital, Thessaloniki, Greece; Interbalkan European Medical Center, Thessaloniki, Greece.
Abstract
BACKGROUND: Left atrial appendage occlusion device embolization (LAAODE) is rare but can have substantial implications on patient morbidity and mortality. Hence, we sought to perform an analysis to understand the timing and clinical consequences of LAAODE. METHODS: A comprehensive search of PubMed and Web of Science databases for LAAODE cases was performed from October 2nd, 2014 to November 1st, 2017. Prior to that, we included published LAAODE cases until October 1st, 2014 reported in the systematic review by Aminian et al. RESULTS: 103 LAAODE cases including Amplatzer cardiac plug (N=59), Watchman (N=31), Amulet (N=11), LAmbre (N=1) and Watchman FLX (N=1) were included. The estimated incidence of device embolization was 2% (103/5,000). LAAODE occurred more commonly in the postoperative period compared with intraoperative (61% vs. 39%). The most common location for embolization was the descending aorta 30% (31/103) and left atrium 24% (25/103) followed by left ventricle 20% (21/103). Majority of cases 75% (77/103) were retrieved percutaneously. Surgical retrieval occurred most commonly for devices embolized to the left ventricle, mitral apparatus and descending aorta. Major complications were significantly higher with postoperative LAAODE compared with intraoperative (44.4% vs. 22.5%, p=0.03). CONCLUSIONS: LAAODE is common with a reported incidence of 2% in our study. Post-operative device embolization occurred more frequently and was associated with a higher rate of complications than intraoperative device embolizations. Understanding the timings and clinical sequelae of DE can aid physicians with post procedural follow-up and also in the selection of patients for these procedures.
BACKGROUND: Left atrial appendage occlusion device embolization (LAAODE) is rare but can have substantial implications on patient morbidity and mortality. Hence, we sought to perform an analysis to understand the timing and clinical consequences of LAAODE. METHODS: A comprehensive search of PubMed and Web of Science databases for LAAODE cases was performed from October 2nd, 2014 to November 1st, 2017. Prior to that, we included published LAAODE cases until October 1st, 2014 reported in the systematic review by Aminian et al. RESULTS: 103 LAAODE cases including Amplatzer cardiac plug (N=59), Watchman (N=31), Amulet (N=11), LAmbre (N=1) and Watchman FLX (N=1) were included. The estimated incidence of device embolization was 2% (103/5,000). LAAODE occurred more commonly in the postoperative period compared with intraoperative (61% vs. 39%). The most common location for embolization was the descending aorta 30% (31/103) and left atrium 24% (25/103) followed by left ventricle 20% (21/103). Majority of cases 75% (77/103) were retrieved percutaneously. Surgical retrieval occurred most commonly for devices embolized to the left ventricle, mitral apparatus and descending aorta. Major complications were significantly higher with postoperative LAAODE compared with intraoperative (44.4% vs. 22.5%, p=0.03). CONCLUSIONS: LAAODE is common with a reported incidence of 2% in our study. Post-operative device embolization occurred more frequently and was associated with a higher rate of complications than intraoperative device embolizations. Understanding the timings and clinical sequelae of DE can aid physicians with post procedural follow-up and also in the selection of patients for these procedures.
Authors: Apurva O Badheka; Ankit Chothani; Kathan Mehta; Nileshkumar J Patel; Abhishek Deshmukh; Michael Hoosien; Neeraj Shah; Vikas Singh; Peeyush Grover; Ghanshyambhai T Savani; Sidakpal S Panaich; Ankit Rathod; Nilay Patel; Shilpkumar Arora; Vipulkumar Bhalara; James O Coffey; William O'Neill; Raj Makkar; Cindy L Grines; Theodore Schreiber; Luigi Di Biase; Andrea Natale; Juan F Viles-Gonzalez Journal: Circ Arrhythm Electrophysiol Date: 2014-12-05
Authors: David R Holmes; Shephal K Doshi; Saibal Kar; Matthew J Price; Jose M Sanchez; Horst Sievert; Miguel Valderrabano; Vivek Y Reddy Journal: J Am Coll Cardiol Date: 2015-06-23 Impact factor: 27.203