Catheter-based closure of residual leaks after percutaneous occlusion of the left atrial appendage

• Published in: Catheterization and cardiovascular interventions Vol. 87; no. 7; pp. 1324 - 1330
• Main Authors: Hornung, Marius, Gafoor, Sameer, Id, Dani, Vaskelyte, Laura, Hofmann, Ilona, Franke, Jennifer, Sievert, Horst, Bertog, Stefan C.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.06.2016; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Atrial Appendage - diagnostic imaging; Atrial Appendage - physiopathology; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Echocardiography, Doppler, Color; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Equipment Design; Female; Fluoroscopy; Germany; Humans; left atrial appendage; left atrial appendage closure; Male; Radiography, Interventional - methods; residual leak; Retreatment; Stroke - etiology; Stroke - prevention & control; Time Factors; Treatment Outcome; atrial fibrillation; residual leak; left atrial appendage; left atrial appendage closure
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.26318

Introduction The purpose of this study was to evaluate safety and efficacy of catheter‐based occlusion of residual leaks after percutaneous closure of the left atrial appendage (LAA). Methods All cases of LAA closure at our center were reviewed to identify secondary interventions for residual leaks. Leaks with a width of more than 3 mm by transesophageal echocardiography (TEE) were considered relevant. In a case‐specific approach, depending on the respective morphology of the defect, either an LAA occlusion device or an Amplatzer Vascular Plug was implanted under TEE and fluoroscopic guidance. Results Between June 2003 and December 2013, 12 patients underwent residual leak closure. All procedures were technically successful and without complications. In 10 cases (83%), complete sealing was confirmed at TEE follow‐up. In 2 patients, minimal gaps (2–3 mm) persisted and anticoagulation was continued. None of the patients had strokes during the follow‐up period. Conclusion Percutaneous residual leak closure after attempted LAA occlusion can be done safely and with high procedural success rates. © 2015 Wiley Periodicals, Inc.