Safety and efficacy of left atrial appendage occlusion with the ACP or Watchman device guided by intracardiac echocardiography from the left atrium.
ICE
left appendage
local anesthesia
percutaneous occlusion
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
22
06
2021
received:
27
09
2020
accepted:
29
06
2021
pubmed:
10
9
2021
medline:
16
10
2021
entrez:
9
9
2021
Statut:
ppublish
Résumé
There is a paucity of randomized data regarding the safety and efficacy of the use of intracardiac echocardiography (ICE) from the left atrium (LA) to guide left atrial appendage occlusion (LAAO) procedures under local anesthesia using either of the available devices. The aim of this study was to compare the efficacy and safety of ICE from the LA with transesophageal echocardiography (TEE) for guidance during transcatheter LAAO procedures. Single-center, cohort study of patients undergoing LAAO with the Amplatzer Cardiac Plug or Watchman device. Procedures were guided by ICE from the LA with local anesthesia (n = 175) or TEE under general anesthesia (n = 49). Efficacy outcomes were procedural success and peri-device leaks 6 weeks after LAAO. The safety outcome was a composite of procedure-related complications. Procedural success was similar between groups: 100% in the TEE-guided group, and 98% in the ICE-guided group. Procedure-related complications such as death, embolism, migration, or major vascular complications occurred similarly between groups (p = 0.590). The rate and degree of peri-device leaks or presence of a thrombus on the device did not differ between groups on follow-up CT. Turnover time in the catheter laboratory and use of contrast agent were reduced with ICE. ICE in the left atrium to guide LAAO procedures appears to be as effective and safe as TEE. There was no increase in procedure-related complications, whatever the device used. ICE resulted in similar procedural success while decreasing procedure time and requiring only local anesthesia.
Sections du résumé
BACKGROUND
BACKGROUND
There is a paucity of randomized data regarding the safety and efficacy of the use of intracardiac echocardiography (ICE) from the left atrium (LA) to guide left atrial appendage occlusion (LAAO) procedures under local anesthesia using either of the available devices.
HYPOTHESIS
OBJECTIVE
The aim of this study was to compare the efficacy and safety of ICE from the LA with transesophageal echocardiography (TEE) for guidance during transcatheter LAAO procedures.
METHODS
METHODS
Single-center, cohort study of patients undergoing LAAO with the Amplatzer Cardiac Plug or Watchman device. Procedures were guided by ICE from the LA with local anesthesia (n = 175) or TEE under general anesthesia (n = 49). Efficacy outcomes were procedural success and peri-device leaks 6 weeks after LAAO. The safety outcome was a composite of procedure-related complications.
RESULTS
RESULTS
Procedural success was similar between groups: 100% in the TEE-guided group, and 98% in the ICE-guided group. Procedure-related complications such as death, embolism, migration, or major vascular complications occurred similarly between groups (p = 0.590). The rate and degree of peri-device leaks or presence of a thrombus on the device did not differ between groups on follow-up CT. Turnover time in the catheter laboratory and use of contrast agent were reduced with ICE.
CONCLUSIONS
CONCLUSIONS
ICE in the left atrium to guide LAAO procedures appears to be as effective and safe as TEE. There was no increase in procedure-related complications, whatever the device used. ICE resulted in similar procedural success while decreasing procedure time and requiring only local anesthesia.
Identifiants
pubmed: 34498285
doi: 10.1002/clc.23696
pmc: PMC8495078
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1402-1408Subventions
Organisme : This work was supported by the University Hospital of Dijon and the Faculty of Medicine of Dijon
Informations de copyright
© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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