scholarly journals Clinical Impact of Preprocedural CT-Based 3D Computational Simulation of Left Atrial Appendage Occlusion with Amulet

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ian Buysschaert ◽  
Dries Viaene
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Computational Simulation ◽  
Clinical Impact ◽  
Atrial Appendage ◽  
Size Selection ◽  
Left Atrial Appendage Occlusion ◽  
Degree Of Confidence ◽  
Implanted Device ◽  
Device Size

Aims. Standard of care (SoC) device size selection with transoesophageal echocardiography (TOE) and computed tomography (CT) in LAAO can be challenging due to a certain degree of variability at both patient and device levels. The aim of this study was to prospectively evaluate the clinical impact of 3D computational modelling software in the decision-making of left atrial appendage occlusion (LAAO) with Amplatzer Amulet. Methods and Results. SoC preprocedural assessments as well as CT-based 3D computational simulations (FEops) were performed in 15 consecutive patients scheduled for LAAO with Amulet. Preprocedural device size selection and degree of confidence were determined after SoC and after FEops-based assessments and compared to the implanted device. FEops-based preprocedural assessment correctly selected the implanted device size in 11 out of 15 patients (73.3%), compared to 7 patients (46.7%) for SoC-based assessment. In 4 patients (26.7%), FEops induced a change in device size initially selected by SoC. In the 7 patients (46.7%) in which FEops confirmed the SoC device size selection, the degree of confidence of the size selection increased from 6.4 ± 1.4 for SoC to 8.1 ± 0.7 for FEops. One patient (6.7%) could not be implanted for anatomical reason, as correctly identified by FEops. Conclusions. Preprocedural 3D computational simulation by FEops impacts Amulet size selection in LAAO compared to TOE and CT-based SoC assessment. Operators could consider FEops computational simulation in their preprocedural device size selection.

scholarly journals Multimodality Imaging for Optimal Device-size Selection During Percutaneous Left Atrial Appendage Closure in Thai Population

2021 ◽  
Author(s):  
Sakolwat Montrivade ◽  
Vorarit Lertsuwunseri ◽  
Monravee Tumkosit ◽  
Suphot Srimahach
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Landing Zone ◽  
Zone Diameter ◽  
Size Selection ◽  
The Mean ◽  
Implanted Device ◽  
Device Size ◽  
Laa Closure

Abstract Background: Optimal device size selection is crucial for percutaneous left atrial appendage (LAA) closure. Transesophageal echocardiography (TEE) is the standard imaging technique for LAA assessment, however there are discrepancies among different imaging modalities. We aimed to evaluate the agreement between device size and LAA size measured by three methods: multi-detector cardiac computed tomography (MDCT), TEE, and angiography. Methods: Patients who underwent percutaneous LAA closure at King Chulalongkorn Memorial Hospital from 2012 to 2020 were included in this study. MDCT, TEE and angiography were reviewed. LAA ostial diameter, landing zone diameter and maximal depth from each imaging modality was measured and analyzed. Agreement between landing zone diameter and implanted device size was assessed.Results: We reported on 61 consecutive patients who underwent percutaneous LAA closure. The mean age of patients was 74.0 ± 8.4 years. The mean CHA2DS2 score, CHA2DS2-VASc score and HAS-BLED score were 2.8 ± 1.4, 4.6 ± 1.8 and 2.6 ± 1.0, respectively. Device implantation was successful in all patients (100%). Two different LAA closure devices were used: Watchman (n = 43, 70.5%) and Omega (n = 18, 29.5%). Maximum landing zone diameter measured by MDCT scan, TEE and angiography were 23.4 ± 3.9 mm, 22.2 ± 4.8 mm and 22.7 ± 3.5 mm, respectively. MDCT measurement was significantly larger than TEE measurement (p = 0.015) and closer to implanted device size compared with TEE and angiography. The difference between landing zone diameter measured by CT scan and device size was -1.65 ± 2.0 mm compared with -4.8 ± 4.6 mm for TEE and -4.3 ± 3.3 mm for angiography.Conclusion: MDCT sizing of LAA results in larger measurement than TEE. Routine implementation of MDCT sizing may improve procedural success with more accurate device size selection.

scholarly journals Incidence and Clinical Impact of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion

2018 ◽  
Vol 4 (12) ◽  
pp. 1629-1637 ◽  
Author(s):  
Mohamad Alkhouli ◽  
Tatiana Busu ◽  
Kuldeep Shah ◽  
Mohammed Osman ◽  
Fahad Alqahtani ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Clinical Impact ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

scholarly journals TCT-203 Incidence and Clinical Impact of Device Related Thrombus after Percutaneous Left Atrial Appendage Occlusion; A Meta-Analysis

2018 ◽  
Vol 72 (13) ◽  
pp. B86
Author(s):  
Mohamad Adnan Alkhouli ◽  
Tatiana Busu ◽  
Kuldeep Shah ◽  
Mohammed Osman ◽  
Fahad Alqahtani ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Meta Analysis ◽  
Clinical Impact ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

Incidence and clinical impact of major bleeding following left atrial appendage occlusion: insights from the Amplatzer Amulet Observational Post-Market Study

2021 ◽  
Vol 17 (9) ◽  
pp. 774-782
Author(s):  
Adel Aminian ◽  
Ole De Backer ◽  
Jens Erik Nielsen-Kudsk ◽  
Patrizio Mazzone ◽  
Sergio Berti ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Clinical Impact ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Post Market

scholarly journals Pre-procedural Determination of Device Size in Left Atrial Appendage Occlusion Using Three-dimensional Cardiac Computed Tomography

2021 ◽  
Author(s):  
Iksung Cho ◽  
William D. Kim ◽  
Oh Hyun Lee ◽  
Min Jae Cha ◽  
Jiwon Seo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Left Atrial ◽  
Cardiac Ct ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Three Dimensional ◽  
Atrial Appendage ◽  
Landing Zone ◽  
Left Atrial Appendage Occlusion ◽  
Device Size

Abstract Background: The two-dimensional-based LAAO size prediction system using transesophageal echocardiography is limited by the complex structure of the left atrial appendage (LAA). The LAA anatomy can be evaluated more precisely using three-dimensional images from cardiac CT; however, a CT-based sizing method has not been established. We aimed to assess the accuracy of measurements derived from cardiac computed tomography (CT) images for selecting left atrial appendage occlusion (LAAO) devices.Methods: We retrospectively reviewed 62 patients with Amplatzer Cardiac Plug and Amulet LAAO devices who underwent implantation from 2017 to 2020. The minimal, maximal, average, area-derived, and perimeter-derived diameters of the LAA landing zone were measured using CT-based images. Predicted device sizes using sizing charts were compared with actual successfully implanted device sizes.Results: The mean size of implanted devices was 27.1 ± 3.7 mm. The perimeter-derived diameter predicted device size most accurately (mean error = -0.8 ± 2.4 mm). All other parameters showed significantly larger error (mean error; minimal diameter = -4.9 ± 3.3 mm, maximal diameter = 1.0 ± 2.9 mm, average diameter = -1.6 ± 2.6 mm, area-derived diameter = -2.0 ± 2.6 mm) than the perimeter-derived diameter (all p for difference <0.05). The error for other parameters were larger in cases with more eccentrically-shaped landing zones, while the perimeter-derived diameter had minor error regardless of eccentricity. When oversizing was used, all parameters showed significant disagreement.Conclusions: The perimeter-derived diameter on cardiac CT images provided the most accurate estimation of LAAO device size regardless of landing zone eccentricity. Oversizing was unnecessary when using cardiac CT to predict an accurate LAAO size.

scholarly journals Semiautomatic Estimation of Device Size for Left Atrial Appendage Occlusion in 3-D TEE Images

2019 ◽  
Vol 66 (5) ◽  
pp. 922-929 ◽  
Author(s):  
Pedro Morais ◽  
Joao L. Vilaca ◽  
Sandro Queiros ◽  
Pieter De Meester ◽  
Werner Budts ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion ◽  
Device Size

Rationale and trial design of the Left Atrial Appendage Occlusion Study (LAAOS III)

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
W. Reents ◽  
A. Diegeler ◽  
J. Babin-Ebell ◽  
A. Böning ◽  
R.P. Whitlock
Keyword(s):  
Left Atrial ◽  
Trial Design ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion

scholarly journals Left Atrial Appendage Occlusion

2020 ◽  
Vol 12 (1) ◽  
pp. xiii
Author(s):  
Ranjan K. Thakur ◽  
Andrea Natale
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Occlusion
Sign in / Sign up

Export Citation Format

Share Document