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Related Concept Videos

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Related Experiment Video

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Ad hoc percutaneous left atrial appendage closure.

Fabian Nietlispach1, René Krause, Ahmed Khattab

  • 1Swiss Cardiovascular Center Bern, Bern University Hospital, 3010 Bern, Switzerland. bernhard.meier@insel.ch.

The Journal of Invasive Cardiology
|December 4, 2013
PubMed
Summary

Ad hoc left atrial appendage (LAA) closure is feasible without transesophageal echocardiography (TEE). This minimally invasive procedure uses local anesthesia and fluoroscopy for atrial fibrillation patients.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Transesophageal echocardiography (TEE) is often required for left atrial appendage (LAA) closure.
  • Omitting TEE may simplify the procedure and reduce costs.

Purpose of the Study:

  • To assess the feasibility of performing ad hoc LAA closure.
  • To determine if TEE can be omitted during the procedure.

Main Methods:

  • Patients with atrial fibrillation underwent same-day LAA closure and coronary angiography.
  • Transesophageal echocardiography (TEE) and sedation were omitted.
  • Left atrial access was achieved via patent foramen ovale or transseptal puncture.
  • Contrast injection excluded LAA thrombus; sheath outer diameter estimated landing zone.
  • Amplatzer Cardiac Plug deployed under fluoroscopy.

Main Results:

  • 13 patients (median CHA2DS2-VASc score 5) underwent successful LAA closure.
  • No thrombus was detected via contrast injection.
  • Procedures were uneventful; device position confirmed by echocardiography.
  • Patients discharged on dual antiplatelet therapy.

Conclusions:

  • Ad hoc LAA closure is feasible using only local anesthesia and fluoroscopy.
  • This approach may offer a simplified alternative for LAA closure.