Amplatzer left atrial appendage occlusion through a patent foramen ovale

Körmendy, Dezsö; Nietlispach, Fabian; Shakir, Samera; Glökler, Steffen; Wenaweser, Peter Martin; Windecker, Stephan; Khattab, Ahmed Aziz; Meier, Bernhard (2014). Amplatzer left atrial appendage occlusion through a patent foramen ovale. Catheterization and cardiovascular interventions, 84(7), pp. 1190-1196. Wiley-Blackwell 10.1002/ccd.25354

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OBJECTIVES: To assess feasibility and outcomes of left atrial appendage (LAA) closure when using a patent foramen ovale (PFO) for left atrial access. Background: Because of the fear of entering the left atrium too high, using a PFO for left atrial access during LAA occlusion (LAAO) is generally discouraged. We report our single-center experience using a concomitant PFO for LAAO, thereby avoiding transseptal puncture. METHODS: LAAO was performed with local anesthesia and fluoroscopic guidance only (no echocardiography). The Amplatzer Cardiac Plug (ACP) was used in all patients. After LAAO, the PFO was closed at the same sitting, using an Amplatzer occluder through the ACP delivery sheath. Patients were discharged the same or the following day on dual antiplatelet therapy for 1-6 months, at which time a follow-up transesophageal echocardiogram (TEE) was performed. RESULTS: In 49 (96%) of 51 patients (35 males, age 70.9 ± 11.9 years), LAAO was successful using the PFO for left atrial access. In one patient, a long tunnel PFO precluded LAAO, which was performed via a more caudal transseptal puncture. In a second patient, a previously inserted ASD occluder precluded LAAO, which was abandoned because of pericardial bleeding. PFO closure was successful in all patients. Follow-up TEE was performed in 43 patients 138 ± 34 days after the procedure. It showed proper sitting of both devices in all patients. CONCLUSIONS: Using a PFO for LAAO had a high success rate and could be the default access in all patients with a PFO, potentially reducing procedural complications arising from transseptal puncture.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Körmendy, Dezsö; Nietlispach, Fabian; Shakir, Samera; Glökler, Steffen; Wenaweser, Peter Martin; Windecker, Stephan; Khattab, Ahmed Aziz and Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Dezsö Körmendy

Date Deposited:

05 Jun 2014 14:06

Last Modified:

26 Jun 2016 01:46

Publisher DOI:

10.1002/ccd.25354

PubMed ID:

24399612

Additional Information:

Early View (Online Version of Record published before inclusion in an issue)

BORIS DOI:

10.7892/boris.41939

URI:

https://boris.unibe.ch/id/eprint/41939

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