Tesi etd-12302021-102216
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Tipo di tesi
Master di Secondo Livello
Autore
EUSEBIO, GEPPINA
URN
etd-12302021-102216
Titolo
left atrial appendage closure with "mother and child" double watchman flx: a case report, a new perspective.
Struttura
Istituto di Scienze della Vita
Corso di studi
Corsi Alta Formazione - PERCUTANEOUS INTERVENTIONAL TREATMENT OF STRUCTURAL HEART DISEASES
Commissione
relatore Prof. BERTI, SERGIO
Membro Prof. PASSINO, CLAUDIO
Membro Prof. PASSINO, CLAUDIO
Parole chiave
- atrial fibrillation
- double device
- left atrial appendage closure
Data inizio appello
21/01/2022;
Disponibilità
parziale
Riassunto analitico
Left atrial appendage (LAA) closure (LAAC) is an alternative to anticoagulant therapy to prevent thromboembolic events in selected patients affected by atrial fibrillation. In some rare cases of very complex anatomy, a complete closure may not always be obtained with a single device.
Careful evaluation of the LAA anatomy is mandatory to obtain a good position of the devices and reduce the risk of embolization, deformation and inter-device residual flow.
We report and discuss a case of a bilobated LAA with a very large ostium successfully closed with two devices in a “mother and child” fashion.
We performed a pre-procedural transesophageal echo-cardiographic (TEE) examination, that documented an enlarged left atrium without an intracardiac thrombus, bilobated LAA with a “broccoli” morphology and a large ostium with a diameter range of 24-27 mm. We did not deem a computed tomography (CT) scan to be necessary since the TEE provided all the necessary information. Both the devices were successfully implanted using the same delivery sheath. Angiogram and TEE showed a good sealing of the ostium and no evidence of residual LAA blood flow.
Careful evaluation of the LAA anatomy is mandatory to obtain a good position of the devices and reduce the risk of embolization, deformation and inter-device residual flow.
We report and discuss a case of a bilobated LAA with a very large ostium successfully closed with two devices in a “mother and child” fashion.
We performed a pre-procedural transesophageal echo-cardiographic (TEE) examination, that documented an enlarged left atrium without an intracardiac thrombus, bilobated LAA with a “broccoli” morphology and a large ostium with a diameter range of 24-27 mm. We did not deem a computed tomography (CT) scan to be necessary since the TEE provided all the necessary information. Both the devices were successfully implanted using the same delivery sheath. Angiogram and TEE showed a good sealing of the ostium and no evidence of residual LAA blood flow.
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