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Experience of Combined Procedure during Percutaneous LAA Closure
Introduction: Percutaneous left atrial appendage closure (LAAC) is an alternative to oral anticoagulants (OAC) in patients with non-valvular atrial fibrillation (AF) and contraindication to long-term OAC. Combined strategy with percutaneous LAAC at the same time of other cardiac structural or electr...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224581/ https://www.ncbi.nlm.nih.gov/pubmed/35743351 http://dx.doi.org/10.3390/jcm11123280 |
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author | Domain, Guillaume Dognin, Nicolas O’Hara, Gilles Rodès-Cabau, Josep Paradis, Jean-Michel Strubé, Camille Bernier, Mathieu O’Connor, Kim Beaudoin, Jonathan Philippon, François Salaun, Erwan Champagne, Jean |
author_facet | Domain, Guillaume Dognin, Nicolas O’Hara, Gilles Rodès-Cabau, Josep Paradis, Jean-Michel Strubé, Camille Bernier, Mathieu O’Connor, Kim Beaudoin, Jonathan Philippon, François Salaun, Erwan Champagne, Jean |
author_sort | Domain, Guillaume |
collection | PubMed |
description | Introduction: Percutaneous left atrial appendage closure (LAAC) is an alternative to oral anticoagulants (OAC) in patients with non-valvular atrial fibrillation (AF) and contraindication to long-term OAC. Combined strategy with percutaneous LAAC at the same time of other cardiac structural or electrophysiological procedures has emerged as an alternative to a staged strategy. Aim: To describe our experience with combined LAAC procedures using Watchman™ devices. Methods: All patients with combined LAAC procedures using Watchman™ (WN) devices performed from 2016 to 2021 were included. The primary safety endpoint was a composite of periprocedural complications and adverse events during the follow-up. The primary efficacy endpoint included strokes, systemic embolisms, major bleeding and cardiovascular death. Results: From 2016, among 160 patients who underwent LAAC using WN devices, 19 underwent a combined strategy: 7 transcatheter edge-to-edge mitral valve repair (TEMVR) (37%), 6 typical atrial flutter ablation (31%), 2 leadless pacemaker (LP) implantation (10%) and 4 AF ablation (22%). The WN device was successfully implanted in 98% and 100% of cases for single and combined LAAC procedures, respectively (p = 0.63). Median follow-up was 13 months (IQR 25/75 3/24). Device-related complications occurred in 6 out of 141 patients (4%) who underwent single LAAC and in no (0/19) patient in the combined LAAC procedure (p = ns). The procedural-related complications did not differ significantly between groups (5% vs. 10%, respectively, in the single and combined group, p = 0.1). Conclusion: Combined procedure using the Watchman™ devices and one other structural or electrophysiological procedure appears safe and effective. Larger series are needed to confirm these results. |
format | Online Article Text |
id | pubmed-9224581 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92245812022-06-24 Experience of Combined Procedure during Percutaneous LAA Closure Domain, Guillaume Dognin, Nicolas O’Hara, Gilles Rodès-Cabau, Josep Paradis, Jean-Michel Strubé, Camille Bernier, Mathieu O’Connor, Kim Beaudoin, Jonathan Philippon, François Salaun, Erwan Champagne, Jean J Clin Med Article Introduction: Percutaneous left atrial appendage closure (LAAC) is an alternative to oral anticoagulants (OAC) in patients with non-valvular atrial fibrillation (AF) and contraindication to long-term OAC. Combined strategy with percutaneous LAAC at the same time of other cardiac structural or electrophysiological procedures has emerged as an alternative to a staged strategy. Aim: To describe our experience with combined LAAC procedures using Watchman™ devices. Methods: All patients with combined LAAC procedures using Watchman™ (WN) devices performed from 2016 to 2021 were included. The primary safety endpoint was a composite of periprocedural complications and adverse events during the follow-up. The primary efficacy endpoint included strokes, systemic embolisms, major bleeding and cardiovascular death. Results: From 2016, among 160 patients who underwent LAAC using WN devices, 19 underwent a combined strategy: 7 transcatheter edge-to-edge mitral valve repair (TEMVR) (37%), 6 typical atrial flutter ablation (31%), 2 leadless pacemaker (LP) implantation (10%) and 4 AF ablation (22%). The WN device was successfully implanted in 98% and 100% of cases for single and combined LAAC procedures, respectively (p = 0.63). Median follow-up was 13 months (IQR 25/75 3/24). Device-related complications occurred in 6 out of 141 patients (4%) who underwent single LAAC and in no (0/19) patient in the combined LAAC procedure (p = ns). The procedural-related complications did not differ significantly between groups (5% vs. 10%, respectively, in the single and combined group, p = 0.1). Conclusion: Combined procedure using the Watchman™ devices and one other structural or electrophysiological procedure appears safe and effective. Larger series are needed to confirm these results. MDPI 2022-06-08 /pmc/articles/PMC9224581/ /pubmed/35743351 http://dx.doi.org/10.3390/jcm11123280 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Domain, Guillaume Dognin, Nicolas O’Hara, Gilles Rodès-Cabau, Josep Paradis, Jean-Michel Strubé, Camille Bernier, Mathieu O’Connor, Kim Beaudoin, Jonathan Philippon, François Salaun, Erwan Champagne, Jean Experience of Combined Procedure during Percutaneous LAA Closure |
title | Experience of Combined Procedure during Percutaneous LAA Closure |
title_full | Experience of Combined Procedure during Percutaneous LAA Closure |
title_fullStr | Experience of Combined Procedure during Percutaneous LAA Closure |
title_full_unstemmed | Experience of Combined Procedure during Percutaneous LAA Closure |
title_short | Experience of Combined Procedure during Percutaneous LAA Closure |
title_sort | experience of combined procedure during percutaneous laa closure |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224581/ https://www.ncbi.nlm.nih.gov/pubmed/35743351 http://dx.doi.org/10.3390/jcm11123280 |
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