Purpose: To bridge neo-endothelialization (NE) of implanted left atrial appendage closure (LAA/LAAC) devices, dual antiplatelet therapy is prescribed. Cardiac computed tomography angiography (cCTA) has been proposed for the evaluation of interventional LAAC. This prospective longitudinal observational study applied a standardized imaging protocol to detect progression of NE of LAAC devices 6 months after implantation.
View Article and Find Full Text PDFIntroduction: The catheter-based left atrial appendage closure (LAAC) has evolved as an alternative to oral anticoagulation (OAC) among non-valvular atrial fibrillation (AF) patients in whom long-term OAC is contraindicated. In daily practice, however, a sizeable number of patients who have been referred for an LAAC do not receive this intervention. This study aimed primarily to investigate the factors deterring the practice of an LAAC in referred AF patients, and secondarily to compare the complication rates of intervened patients with those who had refused the intervention within 1 year.
View Article and Find Full Text PDFBackground: Although left atrial appendage (LAA) anatomy and topographic relations are well understood, little is known about the impairment of neighboring structures (NBS) by an implanted left atrial appendage closure (LAAC) device. This prospective longitudinal observational study for the first time describes distances of implanted LAA closure (LAAC) devices to NBS using a standardized imaging protocol of cardiac computed tomography angiography (cCTA).
Hypothesis: cCTA imaging is an eligible tool for post-implantation evaluation of LAAC devices and their relation to neighboring structures.
Cardiac computed tomography angiography (cCTA) has recently been proposed for evaluation of successful interventional left atrial appendage closure (LAA/LAAC). This prospective longitudinal observational study aims to assess this proposal by applying a standardized imaging protocol to detect and quantify peri-device leaks (PDL) after LAAC. cCTA datasets of consecutive patients 6 months after successful LAAC were acquired on a third generation dual-source computed tomography system and reconstructed with a slice thickness of 0.
View Article and Find Full Text PDFBackground: Left atrial appendage closure (LAAC) represents the interventional alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF). The metabolism of acylcarnitines was shown to affect cardiovascular diseases. This study evaluates the influence of successful LAAC on the metabolism of acylcarnitines.
View Article and Find Full Text PDFA standardized imaging algorithm by cardiac computed tomography angiography (cCTA) (LOVE-view) was used in 30 patients to evaluate the influence of different left atrial appendage (LAA) morphologies on development of thrombosis in the LAA 6 months after implantation of an occlusion device (Watchman or Amplatzer-Cardiac-Plug) in patients with non-valvular atrial fibrillation, CHADS-VASc-Score >1 and a contraindication for oral anticoagulation. The distribution of different LAA morphologies was 40% windsock, 17% broccoli and 43% chicken wing type. There was no significant difference in the level of thrombosis regarding LAA morphology or the type of chosen occlusion device.
View Article and Find Full Text PDFBackground: Iatrogenic aorto-coronary dissections following percutaneous coronary interventions (PCI) represent a rare but potentially life threatening complication. This restrospective and observational study aims to describe our in-house experience for timely diagnostics and therapy including cardiovascular imaging to follow-up securely high-risk patients with Dunning dissections.
Methods: Dunning dissections (DD) occurred during clinical routine PCIs, which were indicated according to current ESC guidelines.
The left atrial appendage (LAA) represents both a predisposing source of thrombus formation and of neuro-humoral haemostasis. This study aims to evaluate changes of biomarker expression before and after successful percutaneous closure of the LAA. Patients with atrial fibrillation and contraindication for oral anticoagulant therapy were enrolled.
View Article and Find Full Text PDFBackground: The interventional left atrial appendage (LAA) closure represents an emerging alternative to oral anticoagulation for stroke prevention in certain atrial fibrillation patients. Preliminary results have suggested high procedural success rates and fewer peri-interventional complications; however, there persists an insufficient understanding of the role of many underlying confounding variables (e.g.
View Article and Find Full Text PDFBackground: To analyze differences of access-site complications related to the height of femoral arterial puncture and the use of a vascular closure device (VCD) following percutaneous coronary intervention (PCI).
Methods: A subgroup of the FERARI study being treated by femoral arterial access and valuable inguinal angiography before implantation of a VCD were included. Inguinal angiographies were systematically reviewed by two independent cardiologists to determine the correct height of femoral arterial puncture.
Background: Snakebites that have cytotoxic venom can cause significant soft tissue swelling. Assessing the site and degree of swelling using ultrasound as a non-invasive technique would be an important tool for instituting appropriate treatment.
Methods: Forty-two patients who presented to a referral hospital in South Africa with cytotoxic swelling of the limbs from snakebite were assessed using ultrasound.
Background: A standardized imaging proposal evaluating implanted left atrial appendage (LAA) occlusion devices by cardiac computed tomography angiography (cCTA) has never been investigated.
Methods: cCTA datasets were acquired on a 3(rd) generation dual-source CT system and reconstructed with a slice thickness of 0.5 mm.
Wilderness Environ Med
March 2016
Objective: We propose a formula as a means to estimate the number and incidence of snakebites treated per annum in KwaZulu Natal (KZN), South Africa.
Methods: Using an unvalidated formula that includes an antivenom ratio, we crudely estimated the total number of snakebite presentations in KZN. Using antivenom supply data from the central pharmacy, we stratified a sample of 6 hospitals that were surveyed to establish an antivenom ratio, that is, the total number of patients receiving antivenom to the total number of snakebite presentations at hospitals.
Intraprocedural device dislodgement of a 24-mm Watchman™ left atrial appendage (LAA) closure device occurred in a 83-year-old female with a wide left atrial appendage ostium (broccoli configuration) and a surgical mitral valve reconstruction. Device rested in the atrial cavity. A second stable 12French transseptal electrophysiological sheath and two snares were needed to stabilize, elongate and gently guide the device into the second sheath.
View Article and Find Full Text PDFBackground: Implantation of left atrial appendage (LAA) occlusion devices was shown to be a feasible and effective alternative to oral anticoagulation in patients with non-valvular atrial fibrillation. However, only few data about in-hospital and peri-procedural data are currently available. This study aims to report about echocardiographic, procedural and in-hospital data of patients receiving LAA occlusion devices.
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