Page 10 - Journal of Structural Heart Disease Volume 1, Issue 4

Meeting Abstracts
Journal of Structural Heart Disease, December 2015, Volume 1, Issue 4: 155-159
DOI: http://dx.doi.org/10.12945/j.jshd.2015.901-15
LAA 2015 Abstracts
How to Close the Left Atrial Appendage
http://www.csi-congress.org/laa
LATVIAN LAA CLOSURE REGISTRY
FIVE YEARS OF EXPERIENCE IN HIGH-RISK PATIENTS Dr. Baiba Lurina1, MD Ainars Rudzitis2, Milda Usane3, Anete Urke3, Mara Katkovska3, Dr. Gunita Lauva4, Prof. Andrejs Erglis5 1 Latvian Centre of Cardiology / Pauls Stradins Clinical University
Hospital / Riga Stradins University, Riga, Latvia; Interventional;
Adult Cardiology, Riga, Latvia
2 Latvian Centre of Cardiology / Pauls Stradins Clinical University
Hospital; Adult Cardiology; Interventional, Kekava, Latvia
3 University of Latvia, Riga, Latvia; Interventional; Adult Cardiology,
Riga, Latvia
4 NHS Grampian, Aberdeen, United Kingdom of Great Britain and
Northern Ireland; Interventional; Adult Cardiology, Aberdeen,
United Kingdom
5 Latvian Centre of Cardiology / Pauls Stradins Clinical University
Hospital / University of Latvia, Riga, Latvia; Interventional; Adult Cardiology, Riga, Latvia
Background: Left atrial appendage (LAA) closure with the Watchman device and AMPLATZER Cardiac Plug (ACP) has been shown to be a safe and e ective alternative to oral anticoagulant therapy. In re- al-world practice in Latvia, LAA closure is preformed in AF patients with high stroke and bleeding risk, distinction from the two random- ized controlled trial of device closure for patients with atrial brilla- tion. LAA 2015
Objectives: The purpose of the Latvian LAA clo prevention in high- risk patients with atrial brillation (AF).
Methods: This is a single centre prospective non-randomized longitu- dinal cohort study of LAA closure with the Watchman device and ACP during ve years. The registry collected data about clinical condition, e cacy and safety events (ischemic/hemorrhagic stroke, death, sys- temic embolism, device thrombosis or embolization, pericardial tam- ponade) from May 2010 to September 2015.
Results: In total 29 LAA closure cases were studied. Successful LAA closure was achieved in 96.6% of cases (n=28). The Watchman device was implanted in 50% and the ACP in 50% of cases. Mean CHA2DS2- VASc score was 6.3 (1.6) and HAS-BLED score - 3.3 (1.0). The main indi-
Published online: December 2015
cation for closure was recurrent ischemic stroke and low compliance with warfarin usage. Serious peri-procedural safety events (device embolization of a Watchman device) occurred in one patient (n=1). Mean follow-up time was 38 (19.8) months, patients followed n=26. During 45 post-procedural days there was one (n=1) device thrombo- sis without clinical sequelae. After day 45, ischemic stroke occurred in 2 patients (2.3 per 100 patient-years) and non-cardiovascular death (from liver cancer) in one patient (1.2 per 100 patient-years).
Conclusions: LAA closure is a safe and e ective method for thrombo- embolic stroke prevention in patients with atrial brillation and high risk of stroke and bleeding.
CROSS-SECTIONAL COMPUTED TOMOGRAPHIC SU- PERIOR TO 2D AND 3D TEE FOR LAA CHARACTERIZA- TION OF SIZE AND THEREFORE DEVICE SELECTION Dee Dee Wang, Marvin Eng, Sachin Parikh, Mehnaz Rahman, Mohammad Zaidan, Adam Greenbaum, William O’Neill Henry Ford Hospital, Detroit, Michigan, USA
Background: Standardized LAA sizing is based on 2D transesopha- geal (TEE) measurements of the left atrial appendage (LAA). However, 3DTEE and CT have proven superior to 2DTEE for multiple structural interventional procedures.
Objective: The aim of this study is to evaluate LAA ostium width and length by 2DTEE, 3DTEE, and CT to determine the optimal imaging modality for accurate device selection.
Methods: From May through August 2015, 22 patients underwent LAA occlusion with WATCHMANTM. All patients received pre- proce- dural CT scan, and intraprocedural 2D and 3D TEE. Maximal width and length of LAA were obtained at 0, 45, 90, 135 degrees by 2D /3DTEE. Paired t-tests were applied to look for di erences between CT sizing and each TEE methodology. Bland-altman plots were applied to com- pare each TEE type to CT.
Results: 22 patients underwent successful implantation of the WATCHMANTM device with CT guided sizing. CT maximal LAA width was larger than 2DTEE (p<0.001) and 3DTEE (p=0.002). CT maximal
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