By Randall Lee MD PhD
This factor of Interventional Cardiology Clinics examines ways to left atrial appendage exclusion. themes contain stroke and bleeding dangers in sufferers with atrial traumatic inflammation, embryology and anatomy, intent, catheter-based endocardial closure, pericardial entry, catheter-based epicardial closure, surgical closure, equipment and left atrial appendage particular attribute for winning closure, medical effects, the position of CTA and MRA imaging, imaging with TEE, post-procedural administration, and prevention and administration of complications.
"…An first-class publication, written via specialists within the field...I might hugely suggest it to scientific and surgical employees drawn to this subject." Reviewed by Perfusion, Apr 2015
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Additional info for Approaches to Left Atrial Appendage Exclusion, An Issue of Interventional Cardiology Clinics
Anticoagulation-associated treatment deficits include major and minor bleeding, a large treatment deficit of patients who either cannot or choose to not take oral anticoagulants, and a persistent risk of ischemic stroke and major adverse cardiovascular events among patients taking oral anticoagulants. The robust series of Watchman device (Coherex Medical, Salt Lake City, UT) trials has demonstrated the Watchman device to provide similar stroke prevention efficacy as warfarin and, by extension, provides proof of concept of LAA closure.
Ann Thorac Surg 1996; 61(2):755–9. 11. Haines DE, Stewart MT, Barka ND, et al. Microembolism and catheter ablation II: effects of cerebral microemboli injection in a canine model. Circ Arrhythm Electrophysiol 2013;6(1):23–30. org/10. 973461. 12. Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001;285(22):2864–70. 13. Camm AJ, Kirchhof P, Lip GY, et al, European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery.
9,15 Because of the varied thickness of the muscle bundles, the endocardial surface appears irregular. 16 The endocardial layer consists of a single layer of endothelial cells, which is supported by subendocardial connective tissue. 18 PATHOLOGIC CHANGES IN THE LAA IN AF The LAA undergoes remodeling during AF and, in chronic AF, the LAA size increases and this Thrombus Formation in the Left Atrial Appendage Fig. 5. CT (A) and MRI (B) scans of cactus LAA morphology. Cactus LAA morphology presents a dominant central lobe with secondary lobes extending from the central lobe in both superior and inferior directions.