Back to Search
Start Over
Intradevice misalignment predicts residual leak in patients undergoing left atrial appendage closure
- Source :
- Journal of cardiovascular medicine (Hagerstown, Md.). 18(11)
- Publication Year :
- 2017
-
Abstract
- Aims: Postdeployment mutual orientation between the disk and the lobe in patients undergoing left atrial appendage closure with Amplatzer cardiac plug/Amulet device might impact on the risk of residual leak during follow-up. Thus, we evaluated in an exploratory, pilot study whether the degree of intradevice misalignment, measured by cardiac computed tomography (CT), discriminates the occurrence of peridevice leak in those patients. Methods: All patients (N = 15) undergoing percutaneous left atrial appendage closure with those specific devices between April 2013 and January 2015 were prospectively included. All patients received follow-up evaluation by cardiac CT at 6 months after the intervention to calculate the angle of misalignment within the device and to detect presence of residual peridevice leak. Results: The angle of misalignment between the disk and the lobe of the device significantly discriminated between patients with and without peridevice leak (area under the curve 0.96, 95% confidence interval 0.88–1.0; P = 0.003), with an angle more than 20° being associated with nine-fold higher risk of residual leak. This angle of intradevice misalignment calculated by cardiac CT was significantly correlated with that measured by two-dimensional transesophageal echocardiography or X-rays in the cath lab after the device deployment (r = 0.943 and r = 0.938, respectively). Conclusion: A marked intradevice misalignment after Amplatzer cardiac plug/Amulet device implantation significantly predicts the occurrence of postprocedural leak in patients with atrial fibrillation; if confirmed by larger studies, these findings may impact on practice patterns.
- Subjects :
- Male
Leak
medicine.medical_specialty
Cardiac Catheterization
Percutaneous
Cath lab
Endoleak
Septal Occluder Device
medicine.medical_treatment
Atrial Appendage
Pilot Projects
030204 cardiovascular system & hematology
left atrial appendage closure
03 medical and health sciences
0302 clinical medicine
Internal medicine
Atrial Fibrillation
medicine
Humans
030212 general & internal medicine
Cardiac catheterization
Aged
Aged, 80 and over
business.industry
Tomography, X-Ray
imaging
leak
Atrial fibrillation
General Medicine
Equipment Design
Middle Aged
medicine.disease
Confidence interval
Echocardiography, Doppler, Color
Treatment Outcome
Cardiology
Equipment Failure
Female
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- ISSN :
- 15582035
- Volume :
- 18
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular medicine (Hagerstown, Md.)
- Accession number :
- edsair.doi.dedup.....b58732078b0f2346937a5cbecb0b0459