BOOK
Left Atrial Appendage Closure, An Issue of Interventional Cardiology Clinics, E-Book
(2018)
Additional Information
Book Details
Abstract
This issue of Interventional Cardiology Clinics, edited by Dr. Apostolos Tzikas, will cover several important elements of Left Atrial Appendage Closure. Articles in this issue include, but are not limited to: Ischemic stroke in atrial fibrillation; History of LAAO; Anatomy of the left atrial appendage, including implications for endocardial and epicardial device closure; Indications, patient selection and referral pathways for LAAO; CT for LAAO; The Watchman device; The Amplatzer Amulet device; and The current device landscape and future perspectives.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| INTERVENTIONAL CARDIOLOGY CLINICS | i | ||
| Copyright | ii | ||
| CONTRIBUTORS | iii | ||
| EDITOR-IN-CHIEF | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| CONTENTS | vii | ||
| Preface: Left Atrial Appendage Occlusion for Stroke Prevention in Patients with Atrial Fibrillation | vii | ||
| A History of Percutaneous Left Atrial Appendage Occlusion with the PLAATO Device | vii | ||
| A History of Left Atrial Appendage Occlusion | vii | ||
| History of Percutaneous Left Atrial Appendage Occlusion with AMPLATZER Devices | vii | ||
| Left Atrial Appendage Occlusion: Data Update | vii | ||
| Indication, Patient Selection, and Referral Pathways for Left Atrial Appendage Closure | viii | ||
| Anatomy and Physiologic Roles of the Left Atrial Appendage: Implications for Endocardial and Epicardial Device Closure | viii | ||
| The WATCHMAN Left Atrial Appendage Closure Device: Technical Considerations and Procedural Approach | viii | ||
| The Amplatzer Amulet Device: Technical Considerations and Procedural Approach | viii | ||
| Echocardiographic Imaging for Left Atrial Appendage Occlusion: Transesophageal Echocardiography and Intracardiac Echocardio ... | ix | ||
| Cardiac Computed Tomography for Left Atrial Appendage Occlusion: Acquisition, Analysis, Advantages, and Limitations | ix | ||
| Incidence, Prevention, and Management of Periprocedural Complications of Left Atrial Appendage Occlusion | ix | ||
| Left Atrial Appendage Occlusion: The Current Device Landscape and Future Perspectives | ix | ||
| Left Atrial Appendage Occlusion, Shared Decision-Making, and Comprehensive Atrial Fibrillation Management | x | ||
| LEFT ATRIAL APPENDAGE CLOSURE | xi | ||
| FORTHCOMING ISSUES | xi | ||
| RECENT ISSUES | xi | ||
| PREFACE:\rLeft Atrial Appendage Occlusion for Stroke Prevention in Patients with Atrial Fibrillation | xiii | ||
| A History of Percutaneous Left Atrial Appendage Occlusion with the PLAATO Device | 137 | ||
| KEY POINTS | 137 | ||
| INTRODUCTION | 137 | ||
| IMAGING OF THE LEFT ATRIAL APPENDAGE | 137 | ||
| PATENT OF A LEFT ATRIAL OCCLUSION DEVICE | 138 | ||
| DEVICE DESCRIPTION | 138 | ||
| ANIMAL STUDIES | 138 | ||
| FIRST IN HUMANS | 139 | ||
| INTERNATIONAL MULTICENTER STUDIES | 140 | ||
| COMPLICATIONS AND PROBLEMS | 140 | ||
| POSTMORTEM ANALYSIS IN HUMANS | 140 | ||
| LONG-TERM FOLLOW-UP | 141 | ||
| ALTERNATIVE TECHNOLOGIES | 141 | ||
| SUMMARY | 141 | ||
| REFERENCES | 141 | ||
| A History of Left Atrial Appendage Occlusion | 143 | ||
| KEY POINTS | 143 | ||
| SUMMARY | 149 | ||
| REFERENCES | 149 | ||
| History of Percutaneous Left Atrial Appendage Occlusion with AMPLATZER Devices | 151 | ||
| KEY POINTS | 151 | ||
| INTRODUCTION | 151 | ||
| DEVELOPMENT OF LEFT ATRIAL APPENDAGE OCCLUSION WITH AMPLATZER DEVICES | 151 | ||
| CLINICAL RESULTS WITH DEDICATED AMPLATZER LEFT ATRIAL APPENDAGE OCCLUSION | 154 | ||
| SUMMARY | 156 | ||
| REFERENCES | 156 | ||
| Left Atrial Appendage Occlusion | 159 | ||
| KEY POINTS | 159 | ||
| INTRODUCTION | 159 | ||
| DATA FOR THE WATCHMAN LEFT ATRIAL APPENDAGE OCCLUDER | 159 | ||
| Late Outcomes of the PROTECT-AF Trial | 160 | ||
| Late Follow Up of the PREVAIL Trial | 161 | ||
| PROTECT-AF and PREVAIL Meta-analysis | 161 | ||
| ASAP Trial Long-Term Follow-up | 161 | ||
| Early WATCHMAN Commercial Experience | 163 | ||
| EWOLUTION Registry | 163 | ||
| AMULET LEFT ATRIAL APPENDAGE OCCLUDER | 164 | ||
| Amulet Global Observational Registry | 164 | ||
| DEVICE THROMBUS | 165 | ||
| EVIDENCE GAPS | 166 | ||
| SUMMARY | 166 | ||
| REFERENCES | 166 | ||
| Indication, Patient Selection, and Referral Pathways for Left Atrial Appendage Closure | 169 | ||
| KEY POINTS | 169 | ||
| INTRODUCTION | 169 | ||
| METHODS OF LEFT ATRIAL APPENDAGE CLOSURE AND CLINICAL EVIDENCE SUPPORTING LEFT ATRIAL APPENDAGE CLOSURE | 170 | ||
| Surgical Methods/Approach | 170 | ||
| Percutaneous Methods/Approach | 170 | ||
| WATCHMAN device | 170 | ||
| AMPLATZER cardiac plug/Amulet | 171 | ||
| WaveCrest device | 172 | ||
| LARIAT endocardial/epicardial suture delivery system | 172 | ||
| PARADOX AND SOLUTION | 173 | ||
| ASAP Registry: Multicenter, Prospective, Observation Registry | 173 | ||
| EWOLUTION Registry | 173 | ||
| Canadian Multicenter Patient-Level Pooled Analysis for Safety and Efficacy of WATCHMAN Device Left Atrial Appendage Closure | 174 | ||
| Left Atrial Appendage Closure with WATCHMAN Versus Novel Oral Anticoagulants | 174 | ||
| INDICATIONS, PATIENT SELECTION, AND CURRENT GUIDELINES FOR LEFT ATRIAL APPENDAGE CLOSURE | 175 | ||
| Potential Benefits and Areas for Future Investigation | 177 | ||
| Left atrial appendage exclusion (LARIAT) as an adjunct to atrial fibrillation ablation | 177 | ||
| Patients with end-stage renal disease and advanced chronic kidney disease | 177 | ||
| Patients with bleeding diatheses | 177 | ||
| Patients with high CHA2DS2-VASc score (5 or more) | 177 | ||
| Patients with symptomatic atrial fibrillation undergoing ablation | 177 | ||
| Cost-effectiveness of left atrial appendage closure | 178 | ||
| Patients Who Should Not Undergo Left Atrial Appendage Closure | 178 | ||
| Post left atrial appendage closure challenges | 178 | ||
| REFERRAL PATHWAY | 178 | ||
| SUMMARY | 179 | ||
| REFERENCES | 180 | ||
| Anatomy and Physiologic Roles of the Left Atrial Appendage | 185 | ||
| KEY POINTS | 185 | ||
| INTRODUCTION | 185 | ||
| DEVELOPMENTAL ANATOMY | 186 | ||
| The WATCHMAN Left Atrial Appendage Closure Device | 201 | ||
| KEY POINTS | 201 | ||
| INTRODUCTION | 201 | ||
| WATCHMAN DEVICE AND DELIVERY SHEATH CHARACTERISTICS | 202 | ||
| Device | 202 | ||
| Delivery Sheath | 202 | ||
| PREPROCEDURAL EVALUATION | 203 | ||
| Anatomic Evaluation for Feasibility | 203 | ||
| PROCEDURAL STEPS | 204 | ||
| Preprocedural Anticoagulation | 205 | ||
| Preprocedural Imaging | 205 | ||
| Venous Access | 205 | ||
| Anticoagulation | 205 | ||
| Transseptal Puncture | 205 | ||
| Delivery Sheath Selection | 206 | ||
| Advancement of Delivery Sheath into the Left Atrial Appendage | 206 | ||
| Final Device Size Selection | 208 | ||
| Device Deployment | 209 | ||
| Device Repositioning and Retrieval | 210 | ||
| Release Criteria | 210 | ||
| SUMMARY | 211 | ||
| REFERENCES | 211 | ||
| The Amplatzer Amulet Device | 213 | ||
| KEY POINTS | 213 | ||
| INTRODUCTION | 213 | ||
| OF THE AMPLATZER AMULET | 213 | ||
| LEFT ATRIAL APPENDAGE OCCLUSION CLOSURE INDICATIONS AND PROCEDURAL PLANNING | 214 | ||
| IMPLANTATION OF THE AMPLATZER AMULET DEVICE: TECHNICAL APPROACH | 214 | ||
| Intraprocedural Imaging | 214 | ||
| Left Atrial Appendage Occlusion Access by the Transseptal Approach | 214 | ||
| Left Atrial Appendage Occlusion Fluoroscopic Calibration and Amulet Device Sizing | 214 | ||
| Delivery Sheath Positioning | 215 | ||
| Device Deployment | 216 | ||
| SPECIAL CONSIDERATIONS | 217 | ||
| Challenging Left Atrial Appendage Occlusion Morphology: The Chicken Wing Anatomy | 217 | ||
| Patients with Refractory Left Atrial Appendage Occlusion Thrombus | 217 | ||
| SUMMARY | 217 | ||
| REFERENCES | 217 | ||
| Echocardiographic Imaging for Left Atrial Appendage Occlusion | 219 | ||
| KEY POINTS | 219 | ||
| UNDERSTANDING LANDMARKS AND IMPACT TO LEFT ATRIAL APPENDAGE OCCLUSION | 220 | ||
| INTRAPROCEDURAL IMAGING-GUIDED THERAPY | 221 | ||
| Key Steps to Successful Left Atrial Appendage Occlusion via Transesophageal Echocardiography | 221 | ||
| Room setup | 221 | ||
| Transseptal puncture | 221 | ||
| Screening and sizing the left atrial appendage landing zone | 223 | ||
| Postdeployment evaluation and surveillance | 223 | ||
| Role of Intracardiac Echocardiographic Imaging in Left Atrial Appendage Occlusion | 223 | ||
| Intracardiac Echocardiographic Imaging Techniques | 225 | ||
| SUMMARY | 227 | ||
| REFERENCES | 227 | ||
| Cardiac Computed Tomography for Left Atrial Appendage Occlusion | 229 | ||
| KEY POINTS | 229 | ||
| INTRODUCTION | 229 | ||
| CARDIAC COMPUTED TOMOGRAPHY FOR ANATOMIC CHARACTERIZATION OF THE LEFT ATRIAL APPENDAGE | 230 | ||
| LEFT ATRIAL APPENDAGE THROMBUS AND CARDIAC COMPUTED TOMOGRAPHIC TECHNIQUES | 231 | ||
| CARDIAC COMPUTED TOMOGRAPHIC ACQUISITION FOR LEFT ATRIAL APPENDAGE OCCLUSION | 232 | ||
| RADIATION EXPOSURE | 234 | ||
| ANALYSIS OF PREPROCEDURAL CARDIAC COMPUTED TOMOGRAPHY FOR FEASIBILITY AND DEVICE SIZING | 234 | ||
| PREPROCEDURAL CARDIAC COMPUTED TOMOGRAPHY COMPARED WITH OTHER IMAGING MODALITIES | 235 | ||
| POSTPROCEDURAL DEVICE-SURVEILLANCE WITH CARDIAC COMPUTED TOMOGRAPHY | 237 | ||
| ADVANTAGES OF CARDIAC COMPUTED TOMOGRAPHY | 238 | ||
| LIMITATIONS | 239 | ||
| SUMMARY | 239 | ||
| SUPPLEMENTARY DATA | 239 | ||
| REFERENCES | 239 | ||
| Incidence, Prevention, and Management of Periprocedural Complications of Left Atrial Appendage Occlusion | 243 | ||
| KEY POINTS | 243 | ||
| INTRODUCTION | 243 | ||
| PERICARDIAL EFFUSION AND CARDIAC TAMPONADE | 244 | ||
| Incidence | 244 | ||
| Classification | 244 | ||
| Mechanism | 245 | ||
| Prevention | 245 | ||
| Treatment | 245 | ||
| DEVICE EMBOLIZATION | 246 | ||
| Incidence, Mechanisms, and Clinical Presentation | 246 | ||
| Prevention | 246 | ||
| Percutaneous Retrieval of an Embolized Left Atrial Appendage Occlusion Device | 247 | ||
| STROKE | 248 | ||
| Air Embolism | 248 | ||
| Prevention | 249 | ||
| Treatment | 249 | ||
| De Novo Equipment Associated with Thrombus Formation | 249 | ||
| Management | 249 | ||
| Embolism of a Preexisting Left Atrial Appendage Thrombus | 249 | ||
| DEVICE-RELATED COMPLICATIONS | 249 | ||
| Left Atrial Appendage Occlusion Device Associated with Thrombus | 249 | ||
| Left Atrial Appendage Occlusion | 253 | ||
| KEY POINTS | 253 | ||
| ENDOCARDIAL APPROACH | 253 | ||
| Amplatzer Cardiac Plug and Amplatzer Amulet | 253 | ||
| Watchman Left Atrial Appendage Device | 255 | ||
| LAmbre | 257 | ||
| Ultraseal | 258 | ||
| The Coherex WaveCrest System | 259 | ||
| OTHER ENDOCARDIAL DEVICES | 260 | ||
| EPICARDIAL APPROACH | 261 | ||
| HYBRID APPROACH | 261 | ||
| FUTURE PERSPECTIVE | 263 | ||
| REFERENCES | 263 | ||
| Left Atrial Appendage Occlusion, Shared Decision-Making, and Comprehensive Atrial Fibrillation Management | 267 | ||
| KEY POINTS | 267 | ||
| INTRODUCTION | 267 | ||
| Case Example | 267 | ||
| THE BALANCE BETWEEN STROKE AND BLEEDING RISK IN ATRIAL FIBRILLATION | 267 | ||
| Stroke Risk in Atrial Fibrillation | 268 | ||
| Anticoagulation and Atrial Fibrillation | 269 | ||
| Bleeding Risk on Anticoagulation | 269 | ||
| THE INTERSECTION OF LEFT ATRIAL APPENDAGE OCCLUSION AND ATRIAL FIBRILLATION ABLATION | 273 | ||
| COMBINED ABLATION/LEFT ATRIAL APPENDAGE OCCLUSION: REVIEW OF THE DATA | 273 | ||
| ROLE OF LEFT ATRIAL APPENDAGE IN ARRHYTHMOGENESIS: CONSIDERATIONS FOR LEFT ATRIAL APPENDAGE OCCLUSION | 274 | ||
| TECHNICAL CONSIDERATIONS FOR PATIENTS UNDERGOING BOTH CATHETER ABLATION AND LEFT ATRIAL APPENDAGE OCCLUSION | 274 | ||
| MANAGEMENT OF ANTICOAGULATION AFTER LEFT ATRIAL APPENDAGE OCCLUSION | 275 | ||
| Oral Anticoagulation After Watchman | 275 | ||
| Oral Anticoagulation After Amplatzer/Amulet | 275 | ||
| Oral Anticoagulation After Lariat | 275 | ||
| Novel Anticoagulants After Left Atrial Appendage Occlusion | 275 | ||
| POSTPROCEDURE IMAGING | 276 | ||
| LEFT ATRIAL APPENDAGE OCCLUSION AND SHARED DECISION-MAKING | 276 | ||
| What Is Shared Decision-Making and How Do We Implement It in Left Atrial Appendage Occlusion? | 277 | ||
| SUMMARY | 280 | ||
| REFERENCES | 280 |