Contrast Enhanced Transesophageal Echocardiographic Guidance of Left Atrial Appendage Closure Device Implantation

2010 ◽  
Vol 23 (9) ◽  
pp. 1007.e3-1007.e4 ◽  
Author(s):  
Michael L. Main ◽  
George G. Latus ◽  
Anthony Magalski ◽  
Kenneth C. Huber
Heart Rhythm ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Erika Hutt ◽  
Oussama M. Wazni ◽  
Simrat Kaur ◽  
Walid I. Saliba ◽  
Khaldoun G. Tarakji ◽  
...  

Author(s):  
Patrick T.J. Hwang ◽  
Jennifer A. Sherwood ◽  
Reid C. Millican ◽  
Pratheek S. Bobba ◽  
Tyler O. Lynd ◽  
...  

Heart Rhythm ◽  
2019 ◽  
Vol 16 (5) ◽  
pp. 663-668 ◽  
Author(s):  
Erika Hutt ◽  
Oussama M. Wazni ◽  
Walid I. Saliba ◽  
Mohamed Kanj ◽  
Khaldoun G. Tarakji ◽  
...  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Hanna ◽  
R Desai ◽  
S Sachdeva ◽  
S Singh ◽  
K Gangani ◽  
...  

Abstract Background Pulmonary artery (PA) injury is a rarely reported complication following percutaneous left atrial appendage closure (LAAC). This study aims to systematically review all reported cases of PA injury associated with LAAC. Methods PubMed/Medline, SCOPUS, EMBASE, Google Scholar and the MAUDE databases were searched to find studies reporting PA injury during or after LAAC with the Amplatzer Amulet (AA), Amplatzer Cardiac Plug (ACP) or Watchman device through October 2019. Categorical data were reported in terms of numbers and/or percentages (%). Results We found 13 cases (mean age 71.4 yrs) with reported PA injury associated with LAAC. Of these, 9 were case reports, 3 were reported in observational studies, and 1 was in the MAUDE database. Most cases (n=8) were reported in Europe followed by Australia (n=2) and Asia (n=2). The indication for device implantation in all patients was a high bleeding risk with anticoagulation for atrial fibrillation. Five cases were reported with the ACP (1/5 patients died), 5 with AA (2/5 patients died), and 3 with the Watchman (1/2 patients died). Acute and late presentations following implantation were reported for all three devices. 69.2% of cases (9/13) occurred acutely (during or within 24 hours of intervention). Of these, 3/9 occurred during device implantation. 2/4 of the delayed cases occurred >2 weeks following implantation. The mortality rate for acute and delayed cases was 22% (2/9 patients) and 50% (2/4 patients), respectively. A majority of the cases were attributable to barb/strut/hook injury of the PA. PA injury was associated with a mortality rate of approximately 31%. All surviving patients were managed with surgical intervention. Conclusion PA injury is an infrequently reported complication following LAAC and is associated with high mortality. Cases can present acutely (intra-procedurally or within 24 hours) or delayed (>24 hours post-implantation). A majority of cases are due to direct injury of the PA by the struts/hooks/barbs of the device. Practitioners should be cognizant of this life-threatening complication, which requires a high index of suspicion for diagnosis and can occur weeks after device implantation. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Stefano Albani ◽  
Nicola Berlier ◽  
Francesco Pisano ◽  
Paolo Scacciatella

Abstract Background Late-onset complications of left atrial appendage occlusion (LAAO) device procedure are anecdotal and there are no such complications reported in literature using Cardia Ultraseal (Cardia, Inc., Eagan, MN, USA). Case summary We report the case of a 74-year-old Caucasian man affected by paroxysmal atrial fibrillation with significant bleeding risk (familiar thrombocytopenia, macroscopic haematuria episodes during therapy with direct oral anticoagulants, HAS-BLED risk score: 4) and ischaemic risk as well (CHADSVASC score: 3). The patient was treated with LAAO device implantation for high bleeding risk. Subsequently, after 26 days from LAAO procedure, he was admitted to the emergency department for haematic cardiac tamponade. The patient was successfully treated with subxyphoidal pericardiocentesis in the acute phase, unfortunately cardiac arrest occurred during the transfer to the referral hospital for urgent cardiac surgery. Permanent neurological damage was reported and the patient died on day 28. Discussion LAAO late-onset complications are very rare and the case presented is the first case described of late-onset pericardial effusion and tamponade secondary to the Cardia Ultraseal LAAO device implantation. We present a revision of the literature regarding the occurrence of similar adverse events and discuss the hypothetical mechanism of this major complication.


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