Steerable Delivery Sheath for Optimized LAA Closure: First Experience and Procedural Outcomes.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2024-12-29 DOI:10.1002/ccd.31390

Matthias Mezger, Christina Paitazoglou, Christian Frerker, Thomas Stiermaier, Ingo Eitel

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引用次数: 0

Abstract

Background: The new Amplatzer Steerable Delivery Sheath is a delivery system designed to improve ease-of-use and procedural results of left atrial appendage closure (LAAC). We aimed to compare procedural results after switching our LAAC program at a tertiary care center with the Amulet device to the Steerable Delivery Sheath, with a control group of LAAC employing the standard sheath.

Methods: The first n = 32 consecutively treated patients at our site using the Amulet device with the Steerable Delivery Sheath were included in this retrospective analysis. As a control-group, n = 39 consecutive patients treated with the Amulet device before the switch to the new sheath were used.

Results: LAAC was successful in all patients in both groups (100%). Contrast use and fluoroscopy time were numerically higher in the steerable sheath group (steerable sheath vs. control group: contrast use 70 ± 23 vs. 55 ± 50 mL, p = 0.09, fluoroscopy time 12.7 ± 4.6 vs. 10.2 ± 6.6 min, p = 0.3). Fluoroscopy time and dose decreased after 3 months while contrast use remained unchanged. Complete sealing rate was high in both groups (steerable sheath vs. control group 97% vs. 95%, p > 0.9) and periprocedural complication rate was low, without any periprocedural stroke, vascular complications, or death in both cohorts.

Conclusions: LAAC with the Amplatzer Amulet steerable delivery sheath is feasible and safe. Fluoroscopy time and dose suggest a learning curve with the new sheath.

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用于优化LAA闭合的可操纵分娩护套：首次经验和手术结果。

背景：新型Amplatzer可操纵给药鞘是一种旨在提高左心耳闭合术（LAAC）的易用性和手术效果的给药系统。我们的目的是比较三级护理中心的LAAC项目使用护身符装置切换到可操纵分娩护套后的程序结果，与使用标准护套的LAAC对照组进行比较。方法：回顾性分析我院使用Amulet装置和可操纵分娩护套连续治疗的第一批患者（n = 32）。作为对照组，n = 39例连续使用Amulet装置治疗的患者在切换到新的护套之前。结果：两组患者LAAC均成功（100%）。可操纵鞘组的对比使用量和透视时间数值较高（可操纵鞘组比对照组：对比使用量70±23 mL比55±50 mL， p = 0.09，透视时间12.7±4.6比10.2±6.6 min, p = 0.3）。3个月后透视时间和剂量减少，而造影剂使用不变。两组的完全闭合率都很高（可操纵鞘对对照组97%对95%，p > 0.9），术中并发症发生率低，两组均无术中卒中、血管并发症或死亡。结论：采用Amplatzer护身符导向分娩护套的LAAC是可行且安全的。透视时间和剂量显示新鞘的学习曲线。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.