Percutaneous closure of the left atrial appendage (LAA) is a new approach to the prevention of cardioembolic events in patients with atrial fibrillation. We implanted an LAA occlusion device (Amplatzer™ Cardiac Plug) in a 70-year-old woman via a transseptal approach. Upon her discharge from the hospital, a transthoracic echocardiogram showed stable anchoring of the device; 6 months after implantation, a routine transthoracic echocardiogram revealed migration of the occluder into the left ventricular outflow tract, in the absence of symptoms. We surgically removed the device from the mitral subvalvular apparatus and closed the LAA with sutures. This case shows that percutaneous LAA occlusion can result in serious adverse events, including device migration in the absence of signs or symptoms; therefore, careful follow-up monitoring is mandatory.
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http://dx.doi.org/10.14503/THIJ-13-3173 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Lübeck, Germany.
Background: The new Amplatzer Steerable Delivery Sheath is a delivery system designed to improve ease-of-use and procedural results of left atrial appendage closure (LAAC). We aimed to compare procedural results after switching our LAAC program at a tertiary care center with the Amulet device to the Steerable Delivery Sheath, with a control group of LAAC employing the standard sheath.
Methods: The first n = 32 consecutively treated patients at our site using the Amulet device with the Steerable Delivery Sheath were included in this retrospective analysis.
Eur Heart J Case Rep
December 2024
Electrophysiology Department, Rede D'Or São Luiz, R. Santo Amaro, 80 - Glória, Rio de Janeiro - RJ, 22211-230, Brazil.
Background: The congenital absence of the left atrial appendage (LAA) is an extremely rare anatomical anomaly, with only 23 cases documented in medical literature. The LAA plays a critical role in thrombus formation, particularly in patients with atrial fibrillation (AF), thus impacting stroke prevention strategies and the management of anticoagulation.
Case Summary: We report a 48-year-old male with a 2-year history of hypertension and prior episodes of tachycardic palpitations, who presented with AF and chest pain.
Eur Stroke J
December 2024
Neurology Department, Hôpital Fondation A. de Rothschild, Paris, France.
Background: Collateral circulation plays a key role in acute ischemic stroke. We sought to determine the association between the arterial collateral status, estimated by the Hypoperfusion Intensity Ratio (HIR) on perfusion MRI, and stroke etiology in anterior circulation large vessel occlusion (LVO).
Methods: We retrospectively analyzed anterior circulation LVO acute stroke patients with a baseline perfusion MRI performed within 24 h from symptom onset.
J Stroke Cerebrovasc Dis
December 2024
Department of Neurology, Asan Medical Center, University of Ulsan, Seoul, South Korea. Electronic address:
Objective: Hemorrhagic transformation (HT) represents a critical complication of reperfusion therapy, often resulting in unfavorable functional outcomes. Our objective was to explore the correlation between endothelial function, assessed through flow-mediated dilation (FMD), and the occurrence of HT in patients undergoing acute reperfusion therapy.
Materials And Methods: In our retrospective analysis, we investigated patients with emergent large vessel occlusion (ELVO) who underwent acute reperfusion therapy and assessment through FMD, calculated as %FMD = (peak diameter - baseline diameter)/baseline diameter×100.
Eur J Heart Fail
November 2024
McMaster University, Hamilton, ON, Canada.
Aims: The left atrial appendage (LAA) produces natriuretic peptides and its removal or occlusion might increase the risk of heart failure (HF). We aimed to investigate the incidence of HF after LAA occlusion or removal (LAAO) in the Left Atrial Appendage Occlusion Study (LAAOS III).
Methods And Results: Patients (n = 4811) with atrial fibrillation (AF) and a CHADS-VASc score ≥2, who were having cardiac surgery for another indication, were randomized to undergo surgical LAAO or not.
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