| Percutaneous epicardial left atrial appendage closure: intermediate-term results. | |
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MedLine Citation:
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PMID: 20662983 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Chronic Percutaneous Epicardial Appendage Closure. Objectives: To assess the chronic safety and feasibility of percutaneous epicardial closure of the left atrial appendage (LAA) guided by electrical navigation. Background: Atrial fibrillation (AF) is associated with stroke, and LAA occlusion may be a useful nonpharmacologic strategy for stroke prevention in AF. Methods: Percutaneous epicardial access was obtained in 6 dogs under general anesthesia. The ligation system included a grabber that captures the LAA guided by local electrograms (EGMs) and a looped hollow suture preloaded with a central wire enabling control and visualization. After a satisfactory position is confirmed the loop is tightened remotely, and the suture cut. Transesophageal echocardiography (TEE) assessed LAA dimensions and flow. LAA EGMs were recorded pre- and postclosure, and neurohormonal markers measured. Pathologic examination was performed. Results: LAA ligation was successful in all dogs. LAA flow was immediately abolished in 5 of 6 dogs. Disappearance of local LAA EGMs following ligation was observed in all animals. Follow-up TEE at mean 54 days (range 23-75 days) documented residual flow in only the first 2 dogs. Prior to necropsy the LAA was examined at thoracotomy in 3 animals. Following a minor design change, complete closure and fibrosis with a remnant atretic LAA was noted in all animals. No damage to adjacent structures was noted. Neurohormonal markers were unchanged. Conclusion: Percutaneous epicardial LAA ligation guided by electrical navigation is feasible with promising intermediate-term results in the canine model. The technique may be useful as an alternative to existing methods of LAA obliteration in humans. (J Cardiovasc Electrophysiol, Vol. 22, pp. 64-70, January 2011). |
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Authors:
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Charles J Bruce; Christopher M Stanton; Samuel J Asirvatham; Andrew J Danielsen; Susan B Johnson; Douglas L Packer; Paul A Friedman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 22 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 64-70 Citation Subset: IM |
Copyright Information:
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© 2010 Wiley Periodicals, Inc. |
Affiliation:
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Division of Cardiovascular Disease, Department of Internal Medicine Mayo Clinic, Rochester, Minnesota, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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