Percutaneous Epicardial Left Atrial Appendage Closure: Preliminary Results of an Electrogram Guided Approach

Página do item simplificado
dc.contributor.authorFriedman, Paul A.
dc.contributor.authorAsirvatham, Samuel J.
dc.contributor.authorDalegrave, Charles [UNIFESP]
dc.contributor.authorKinoshita, Masayoshi
dc.contributor.authorDanielsen, Andrew J.
dc.contributor.authorJohnson, Susan B.
dc.contributor.authorHodge, David O.
dc.contributor.authorMunger, Thomas M.
dc.contributor.authorPacker, Douglas L.
dc.contributor.authorBruce, Charles J.
dc.contributor.institutionMayo Clin
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionMayo Clin Hlth Solut
dc.date.accessioned2016-01-24T13:58:37Z
dc.date.available2016-01-24T13:58:37Z
dc.date.issued2009-08-01
dc.description.abstractBackground: Pharmacologic therapies to prevent stroke in atrial fibrillation (AF) have numerous limitations, prompting the development of device-based therapies. We investigated whether an electrogram-based approach using a novel hollow suture can safely capture and ligate the left atrial appendage (LAA).Methods and Results: A novel system for closure of the LAA within the confines of the closed pericardium with a single sheath puncture was tested in 4 dogs. the tool used to grasp the appendage was fitted with electrodes and utilized electrical navigation to identify and confirm LAA capture. A hollow suture preloaded with a mechanical support wire to permit its manipulation and fluoroscopic visualization was advanced over the grasper, and the wire removed after the suture was positioned. the LAA was successfully closed in all dogs. in 2 dogs, after closure, a thoracotomy was performed and the LAA amputated without bleeding, confirming closure integrity. Necropsy confirmed closure in all animals.Conclusions: Using electrical navigation, percutaneous epicardial LAA ligation with a remotely tightened suture was performed successfully within the confines of the intact pericardial space. This technique may allow decreasing the risk of stroke in AF patients without the need for thoracotomy or an endocardially placed prosthetic device.(J Cardiovasc Electrophysiol, Vol. 20, pp. 908-915, August 2009).en
dc.description.affiliationMayo Clin, Dept Internal Med, Div Cardiovasc Dis, Rochester, MN 55905 USA
dc.description.affiliationMayo Clin, Dept Pediat Cardiol, Div Pediat & Adolescent Med, Rochester, MN 55905 USA
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo Hosp, São Paulo, Brazil
dc.description.affiliationMayo Clin Hlth Solut, Rochester, MN USA
dc.description.affiliationMayo Clin, Dept Hlth Sci Res, Div Biomed Stat & Informat, Rochester, MN 55905 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, São Paulo Hosp, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipAegis Medical (Vancouver, Canada)
dc.description.sponsorshipMayo Discovery Translation Award
dc.format.extent908-915
dc.identifierhttp://dx.doi.org/10.1111/j.1540-8167.2009.01465.x
dc.identifier.citationJournal of Cardiovascular Electrophysiology. Malden: Wiley-Blackwell Publishing, Inc, v. 20, n. 8, p. 908-915, 2009.
dc.identifier.doi10.1111/j.1540-8167.2009.01465.x
dc.identifier.issn1045-3873
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/31737
dc.identifier.wosWOS:000268457600013
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofJournal of Cardiovascular Electrophysiology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.subjectleft atrial appendageen
dc.subjectatrial fibrillationen
dc.subjectstrokeen
dc.subjectepicardialen
dc.subjectelectrogramsen
dc.titlePercutaneous Epicardial Left Atrial Appendage Closure: Preliminary Results of an Electrogram Guided Approachen
dc.typeinfo:eu-repo/semantics/article
Arquivos
Coleções
Em verificação - Geral