Percutaneous left atrial appendage closure using the LAmbre device. First clinical results in Poland

摘要

Introduction In adult populations, atrial fibrillation (AF) is the major arrhythmia and successful treatment rates are low [1]. In recent years, left atrial appendage occlusion (LAAO) has become an alternative method for stroke prevention in patients in whom oral anticoagulation (OAC) is ineffective or contraindicated or in patients with life-threatening complications [2, 3]. Previous studies have demonstrated that the LAAO procedure is safe and effective in the prevention of thromboembolic events, including in high risk patients [4–10]. In the medical market, there are a?number of available devices including endocardial and epicardial devices [4, 5, 9]. However, in some cases, the anatomy of the left atrial appendage (LAA) may constitute a?contraindication to implantation of these devices. The LAmbre device is a?novel system, designed especially for LAA closure when problematic morphology is present [11, 12]. Aim Herein, we present the first use of the LAmbre device in Poland in patients with AF. Material and methods A?retrospective, single-center study was performed in 24 consecutive patients with non-valvular AF, who underwent LAAO with the LAmbre device (Lifetech Scientific Corp., Shenzhen, China) between 2016 and 2018 (Figure 1). The LAmbre occluder system was previously described [13]. LAmbre device selection was based on operators’ decision. All procedures were performed under general anesthesia. Patient characteristics are presented in Table I. The LAA anatomy was assessed with computed tomography angiography before each procedure. Oral anticoagulation therapy was discontinued and unfractionated heparin was used during the procedure. After the procedure, aspirin (75?mg/dose/day) and clopidogrel (75?mg/dose/day) for 6 months were recommended in each patient. Leak was defined as the presence of flow from the left atrium to the LAA 3?mm [14]. Follow-up visits, including transesophageal echocardiography, were performed at 3 and 6 months post-procedure. Data on mortality, causes of mortality and serious adverse events (SAE) were collected. Statistical analysis Data are expressed as mean ± standard deviation or median (interquartile range; Q1 – 25th percentile and Q3 – 75th percentile), unless otherwise stated. Categorical variables were expressed as counts and percentages. Results All procedures were successfully completed with no perioperative complications. The LAAO...