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Percutaneous left atrial appendage (LAA) closure is an emerging technology for thromboembolic prevention in patients with atrial fibrillation (AF). The first human implantation of an LAA device occurred in 2001, and since then four devices have received CE mark approval. These devices are being widely used in Europe for LAA closure in patients who are poor candidates for long-term oral anticoagulation. In the US, the WATCHMAN device (Boston Scientific) is anticipated to receive FDA approval imminently for AF patients who are warfarin-eligible. This approval is projected to significantly expand the indications for LAA closures worldwide. Thus, the volume of procedures is anticipated to escalate. This book discusses the epidemiology of AF as a cause of stroke; the use of LAA closure in the reduction of thromboembolism with AF; early surgical approaches and novel surgical devices for LAA closure; and current percutaneous approaches and devices available for LAA closure. The emphasis of this book is on percutaneous technical approaches and contemporary trial results on the leading devices (PLAATO, WATCHMAN, Amplatzer Cardiac Plug, and LARIAT). It also reviews unapproved devices in development, in both clinical and pre-clinical phases.
Percutaneous left atrial appendage (LAA) closure is an emerging technology for thromboembolic prevention in patients with atrial fibrillation (AF). The first human implantation of an LAA device occurred in 2001, and since then four devices have received CE mark approval. These devices are being widely used in Europe for LAA closure in patients who are poor candidates for long-term oral anticoagulation. In the US, the WATCHMAN device (Boston Scientific) is anticipated to receive FDA approval imminently for AF patients who are warfarin-eligible. This approval is projected to significantly expand the indications for LAA closures worldwide. Thus, the volume of procedures is anticipated to escalate. This book discusses the epidemiology of AF as a cause of stroke; the use of LAA closure in the reduction of thromboembolism with AF; early surgical approaches and novel surgical devices for LAA closure; and current percutaneous approaches and devices available for LAA closure. The emphasis of this book is on percutaneous technical approaches and contemporary trial results on the leading devices (PLAATO, WATCHMAN, Amplatzer Cardiac Plug, and LARIAT). It also reviews unapproved devices in development, in both clinical and pre-clinical phases.
This issue of Interventional Cardiology Clinics, edited by Dr. Apostolos Tzikas, will cover several important elements of Left Atrial Appendage Closure. Articles in this issue include, but are not limited to: Ischemic stroke in atrial fibrillation; History of LAAO; Anatomy of the left atrial appendage, including implications for endocardial and epicardial device closure; Indications, patient selection and referral pathways for LAAO; CT for LAAO; The Watchman device; The Amplatzer Amulet device; and The current device landscape and future perspectives.
Intracardiac Echocardiography is the first echocardiographic textbook of its kind to specifically cover ICE. Discussing all aspects of intracardiac ultrasound, it allows readers to perfect ICE image acquisition and helps to guide interpretation of this information during interventional and electrophysiologic procedures. Unique and informative, the text explores: introductory echo physics currently available intracardiac ultrasound systems basic image acquisition the role of ICE in both the interventional and electrophysiology laboratory, as well as in the diagnostic setting. Featuring expert commentary by leaders in the field, the book also includes high quality echocardiographic images illustrating how ICE is used in a wide variety of procedures such as transseptal catheterization, PFO and ASD closure, atrial fibrillation ablation procedures, and many others.
Continued advances in cardiology have led to unprecedentedscientific progress in recent years. However, no matter howadvanced the science, the successful application of interventionalcardiology relies upon a practitioner’s ability to approachinterventional techniques competently and confidently in everysituation. Fully updated and featuring new chapters and additional tips andtricks, this latest edition of Dr Nguyen, Colombo, Hu, Grines, andSaito’s celebrated book provides a complete yet concise guideto practical interventional cardiology that deserves a place inevery cardiac laboratory. Culled from the personal experience ofover fifty international experts, the book incorporates more than500 practical tips and tricks for performing interventionalcardiovascular procedures. Each strategic or tactical move isgraded by complexity level and described in a simple, step-by-stepapproach that includes guidance on how to overcome practicaldifficulties, providing a comprehensive resource that can benefitboth beginner or experienced operators. As well as covering the latest developments in interventionalcardiology, this third edition includes technical tips that promoteuser-friendly performance, low complication rates, cost- andtime-efficient approaches and cost- and time-effective selection ofdevices to help optimize the practice of modern interventionalcardiology.
In this issue of Cardiac Electrophysiology Clinics, guest editor Dr. Matthew J. Daniels brings his considerable expertise to the topic of Left Atrial Appendage Occlusion. Top experts in the field discuss topics such as pre-cath laboratory planning for left atrial appendage occlusion: optional or essential; the case for intracardiac echo to guide left atrial appendage closure; follow-up imaging after left atrial appendage occlusion: something or nothing and for how long?; left atrial appendage closure: what the evidence does and does not reveal; and more. Contains 11 practice-oriented topics including the strengths and weaknesses of the LAA covering disc occluders; left atrial appendage occlusion strengths and weaknesses of the lobe-only occluder concept in theory and in practice; the strengths and weaknesses of left atrial appendage ligation or exclusion (LARIAT, AtriaClip, Surgical Suture); the future of LAAC—in 5, 10, and 20 years; and more. Provides in-depth clinical reviews on left atrial appendage occlusion, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
In collaboration with the Consulting Editors, Ranjan K. Thakur and Andrea Natale, Drs. Dhanunjaya Lakkireddy, David R. Holmes Jr., and Saibal Kar have assembled an issue of Cardiac Electrophysiology Clinics on Left Atrial Appendage. Topics include, but are not limited to, why we have an atrial appendage, thromboembolism in AF, role of LAA in systemic homeostasis, history of LAA closure, impact of LAA closure on systemic thromboembolization, perirprocedural imaging, anatomical considerations for epicardial and endocardial appendage closure, epicardial vs endocardial closure, technical considerations of endocardial and epicardial closure, surgical LAA occlusion, post procedural management, AF patients undergoing ablation, and more.
This book constitutes the thoroughly refereed post-workshop proceedings of the 8th International Workshop on Statistical Atlases and Computational Models of the Heart: ACDC and MMWHS Challenges 2017, held in conjunction with MICCAI 2017, in Quebec, Canada, in September 2017. The 27 revised full workshop papers were carefully reviewed and selected from 35 submissions. The papers cover a wide range of topics computational imaging and modelling of the heart, as well as statistical cardiac atlases. The topics of the workshop included: cardiac imaging and image processing, atlas construction, statistical modelling of cardiac function across different patient populations, cardiac computational physiology, model customization, atlas based functional analysis, ontological schemata for data and results, integrated functional and structural analyses, as well as the pre-clinical and clinical applicability of these methods. Besides regular contributing papers, additional efforts of STACOM workshop were also focused on two challenges: ACDC and MM-WHS.
In this issue of Interventional Cardiology Clinics, guest editor Dr. Matthew James Daniels brings his considerable expertise to the topic of Left Atrial Appendage Occlusion. Top experts in the field cover key topics such as follow-up imaging after appendage occlusion, completed appendage closure trials and registries, future LAAC trials, and more. - Contains 12 relevant, practice-oriented topics including left atrial thrombus—are all atria and appendages equal?; left atrial appendage occlusion—a choice or a last resort, and how to approach the patient; is pre-cathlab planning for left atrial appendage occlusion optional or essential?; intra-procedureal imaging for appendage occlusion—the case for intracardiac echo; and more. - Provides in-depth clinical reviews on left atrial appendage occlusion, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
This book presents the percutaneous techniques and technologies most frequently employed in structural interventional cardiology, focusing especially on how to optimize outcomes and minimize risk. Interventional procedures for aortic stenosis, mitral regurgitation, left atrial appendage closure, patent foramen ovale closure, and closure of interatrial and interventricular defects are clearly presented step by step with the aid of a wealth of images. These descriptions are complemented by a case-based analysis of the various structural pathologies and their complications. Clear guidance is also provided on patient selection, preoperative evaluation, and choice of available devices. The authors are all acknowledged experts with extensive experience in laboratories and surgical units. The book fully reflects the rapid changes in structural interventional cardiology that have occurred during recent years. These advances are in particular due to the introduction of transcatheter aortic valve implantation, which allows cardiac surgeons to achieve excellent outcomes in patients at high surgical risk. Other exciting developments include new technologies that permit better treatment of other structural cardiac pathologies and valid alternatives to medical therapy in particular patient groups.