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Occluding morphologically complicated left atrial appendage using the small-umbrella LAmbre device.

Hong-Da Zhang1, Ming Yang2, Yang-Bo Xing3

  • 1Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, China.

BMC Cardiovascular Disorders
|July 22, 2022
PubMed
Summary
This summary is machine-generated.

The small-umbrella LAmbre device effectively treats complex left atrial appendage (LAA) anatomy for stroke prevention in atrial fibrillation patients. This LAA occlusion offers a safe alternative when standard devices are unsuitable.

Keywords:
Atrial fibrillationLAmbreLeft atrial appendage occlusionSmall-umbrellaThrombosis

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Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Percutaneous left atrial appendage (LAA) occlusion is a key strategy for stroke prevention in atrial fibrillation.
  • Complex LAA anatomies, including multiple lobes or large orifices, pose challenges for standard occlusion devices.
  • The LAmbre device with a small-umbrella design was developed to address these anatomical complexities.

Purpose of the Study:

  • To evaluate the feasibility, safety, and short-term efficacy of the small-umbrella LAmbre device for LAA occlusion.
  • To assess the device's performance in patients with morphologically complicated LAA.
  • To determine if the LAmbre device is a viable alternative for patients unsuitable for standard LAA occlusion devices.

Main Methods:

  • Retrospective analysis of 129 patients undergoing LAA occlusion with the LAmbre device.
  • Focus on 30 patients who received the small-umbrella LAmbre device.
  • Analysis of patient characteristics, procedural details, and short-term outcomes, including transesophageal echocardiography at 3 months.

Main Results:

  • The small-umbrella LAmbre device was used in 30 patients, 73.3% of whom had multilobed LAA.
  • Successful anchoring of the occluder umbrella was achieved in various LAA structures.
  • No peri-device residual flow was observed at 3-month follow-up in 24 patients.
  • One patient experienced device thrombosis, which resolved with anticoagulation; one patient had an ischemic stroke; no other adverse events were reported.

Conclusions:

  • The small-umbrella LAmbre device demonstrated feasibility, safety, and short-term effectiveness for occluding complex LAA anatomies.
  • This device presents a valuable alternative for atrial fibrillation patients with challenging LAA morphology who cannot be treated with standard occlusion devices.