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Related Concept Videos

Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...

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Pulmonary Ridge Coverage: A Two-edged Sword in Left Atrial Appendage Closure With LAmbre.

Jiaxu Shen1, Yanyan Chen2, Liangguo Wang1

  • 1Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou, PR China.

The Canadian Journal of Cardiology
|February 15, 2025
PubMed
Summary
This summary is machine-generated.

Pulmonary ridge coverage during left atrial appendage closure (LAAC) with the LAmbre device reduced thromboembolic events and device-related thrombus. However, it increased the incidence of nonsignificant peridevice leaks.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Left atrial appendage closure (LAAC) is a common procedure for stroke prevention in patients with nonvalvular atrial fibrillation.
  • The LAmbre occluder offers selective pulmonary ridge (PR) coverage during LAAC.
  • Evaluating the impact of PR coverage on clinical and imaging outcomes is crucial.

Purpose of the Study:

  • To assess the effect of pulmonary ridge coverage using the LAmbre device on imaging and clinical outcomes in patients undergoing LAAC.
  • To compare the incidence of thromboembolic events and device-related thrombus between patients with and without PR coverage.
  • To analyze the occurrence of peridevice leaks in relation to PR coverage.

Main Methods:

  • Retrospective analysis of imaging data and clinical events in 259 patients undergoing LAAC with the LAmbre device.
  • Patients were categorized into PR-covered (n=109) and PR-uncovered (n=150) groups.
  • Primary composite endpoint: thromboembolic events and device-related thrombus. Follow-up included transesophageal echocardiography.

Main Results:

  • The PR-covered group showed a significantly lower incidence of the primary composite endpoint (TE events and DRT) compared to the PR-uncovered group (6.4% vs 14.0%, P=0.046).
  • A trend towards higher device-related thrombus (DRT) incidence was observed in the PR-uncovered group (P=0.056).
  • Any peridevice leak (PDL) was more frequent in the PR-covered group (short-term: 45.9%, long-term: 49.5%), but significant PDLs (>3 mm) did not differ. PR coverage predicted long-term PDL (OR 3.19).

Conclusions:

  • Pulmonary ridge coverage during LAAC with the LAmbre device is associated with a reduced risk of thromboembolic events and device-related thrombus.
  • This benefit is observed despite an increased incidence of nonsignificant peridevice leaks.
  • PR coverage is an independent predictor of long-term peridevice leaks.