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Anduaga I, Affronti A, Cepas-Guillén P, Alcocer J, Flores-Umanzor E, Regueiro A, Brugaletta S, Quintana E, Sanchis L, Sabaté M, Freixa X. Non-Pharmacological Stroke Prevention in Atrial Fibrillation. J Clin Med 2023; 12:5524. [PMID: 37685589 PMCID: PMC10488500 DOI: 10.3390/jcm12175524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Atrial fibrillation (AF) is the most common arrhythmia worldwide. It is associated with increased mortality and morbidity, especially due to the increased risk of ischemic stroke and systemic embolism in these patients. For this reason, thromboembolism prevention is the cornerstone of managing AF, and oral anticoagulation is nowadays the first-line treatment. However, since most thrombi form in the left atrial appendage and anticoagulant therapy may have side effects and be contraindicated in some patients, surgical and percutaneous left atrial appendage occlusion (LAAO) have emerged as a non-pharmacological alternative. This review summarizes all existing evidence on surgical and percutaneous LAAO.
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Affiliation(s)
- Iñigo Anduaga
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Alessandro Affronti
- Cardiovascular Surgery, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Pedro Cepas-Guillén
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Jorge Alcocer
- Cardiovascular Surgery, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Eduardo Flores-Umanzor
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Ander Regueiro
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Salvatore Brugaletta
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Eduard Quintana
- Cardiovascular Surgery, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Laura Sanchis
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Manel Sabaté
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Xavier Freixa
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
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Vainrib AF, Bamira D, Aizer A, Chinitz LA, Loulmet D, Benenstein RJ, Saric M. Photorealistic imaging of left atrial appendage occlusion/exclusion. Echocardiography 2019; 36:1601-1604. [PMID: 31385344 DOI: 10.1111/echo.14438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/27/2019] [Accepted: 06/30/2019] [Indexed: 11/30/2022] Open
Abstract
Recent improvements in 3D TEE post processing rendering techniques referred to as TrueVue (Philips Medical Systems, Andover, MA, USA). It allows for novel photorealistic imaging of cardiac structures including left atrial appendage (LAA) and its closure devices. Here we present TrueVue images of the LAA prior to and after LAA exclusion/occlusion using various percutaneous and surgical techniques. TrueVue may improve delineation of LAA anatomy prior to occlusion as well as visualization of occluder device position within the LAA.
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Affiliation(s)
- Alan F Vainrib
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
| | - Daniel Bamira
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
| | - Anthony Aizer
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
| | - Larry A Chinitz
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
| | - Didier Loulmet
- Division of Cardiothoracic Surgery, New York University Langone Health, New York City, New York
| | - Ricardo J Benenstein
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
| | - Muhamed Saric
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York City, New York
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Sunagawa G, Karimov JH, Breitbach MM, Fukamachi K. Reply to Rescigno et al. Eur J Cardiothorac Surg 2018; 54:197-198. [PMID: 29447343 DOI: 10.1093/ejcts/ezy042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gengo Sunagawa
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jamshid H Karimov
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - May M Breitbach
- Experimental Surgical Services, University of Minnesota, Minneapolis, MN, USA
| | - Kiyotaka Fukamachi
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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Caliskan E, Cox JL, Falk V, Salzberg SP, Emmert MY. Surgical device-enabled epicardial LAA closure to achieve safe, complete, and durable LAA occlusion. Nat Rev Cardiol 2018; 15:191. [PMID: 29434359 DOI: 10.1038/nrcardio.2018.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Etem Caliskan
- Department of Cardiovascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany, and at the Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| | - James L Cox
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Volkmar Falk
- Department of Cardiovascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany, and at the Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| | | | - Maximilian Y Emmert
- Clinic for Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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