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Erschienen in: Clinical Research in Cardiology 4/2014

01.04.2014 | Original Paper

Uncommon delayed and late complications after percutaneous left atrial appendage closure with Amplatzer® Cardiac Plug

verfasst von: Marco R. Schroeter, Bernhard C. Danner, Mark Hünlich, Wolfgang Schillinger

Erschienen in: Clinical Research in Cardiology | Ausgabe 4/2014

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Abstract

Aims

Percutaneous left atrial appendage closure with Amplatzer® Cardiac Plug (St. Jude Medical Inc.) for the prevention of stroke in patients with atrial fibrillation is rapidly propagating. We sought to provide additional safety data.

Methods and results

We have screened our database of patients having been treated with Amplatzer® Cardiac Plug and found 3 cases with uncommon complications that have not been reported previously. One patient experienced an embolisation of the occluder about 12 months after implantation that potentially resulted from mismatch of occluder size and landing zone. Another patient developed cardiac tamponade 9 days after implantation. This case of delayed effusion was probably not a result of interventional trauma, but might have been provoked by scratching of the inner pericardial membrane. A third patient developed a large thrombus in the left atrium which was considered to be caused by injury of the endothelial wall during implantation. The first two cases could be treated by a percutaneous procedure, the last case by cardiac surgery without any sequelae.

Conclusions

Complications after left atrial appendage closure not related to a device-related thrombus can occur later after implantation. With appropriate percutaneous or surgical management these complications can be handled without sequelae.
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Literatur
1.
Zurück zum Zitat Onalan O, Crystal E (2007) Left atrial appendage exclusion for stroke prevention in patients with nonrheumatic atrial fibrillation. Stroke 38:624–630PubMedCrossRef Onalan O, Crystal E (2007) Left atrial appendage exclusion for stroke prevention in patients with nonrheumatic atrial fibrillation. Stroke 38:624–630PubMedCrossRef
2.
Zurück zum Zitat Rodés-Cabau J, Champagne J, Bernier M (2010) Transcatheter closure of the left atrial appendage: initial experience with the Amplatzer cardiac plug device. Catheter Cardiovasc Interv 76:186–192PubMedCrossRef Rodés-Cabau J, Champagne J, Bernier M (2010) Transcatheter closure of the left atrial appendage: initial experience with the Amplatzer cardiac plug device. Catheter Cardiovasc Interv 76:186–192PubMedCrossRef
3.
Zurück zum Zitat Park JW, Bethencourt A, Sievert H, Santoro G, Meier B, Walsh K, Lopez-Minquez JR, Meerkin D, Valdés M, Ormerod O, Leithäuser B (2011) Left atrial appendage closure with Amplatzer cardiac plug in atrial fibrillation: initial European experience. Catheter Cardiovasc Interv 77:700–706PubMedCrossRef Park JW, Bethencourt A, Sievert H, Santoro G, Meier B, Walsh K, Lopez-Minquez JR, Meerkin D, Valdés M, Ormerod O, Leithäuser B (2011) Left atrial appendage closure with Amplatzer cardiac plug in atrial fibrillation: initial European experience. Catheter Cardiovasc Interv 77:700–706PubMedCrossRef
4.
Zurück zum Zitat Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P, PROTECT AF Investigators (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542PubMedCrossRef Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P, PROTECT AF Investigators (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542PubMedCrossRef
5.
Zurück zum Zitat Park JW (2012) Results of the Amplatzer Cardiac Plug European Multicenter Observational Study. Presented at the TCT congress 2012 Park JW (2012) Results of the Amplatzer Cardiac Plug European Multicenter Observational Study. Presented at the TCT congress 2012
6.
Zurück zum Zitat Guérios EE, Schmid M, Gloekler S, Khattab AA, Wenaweser PM, Windecker S, Meier B (2012) Left atrial appendage closure with the Amplatzer cardiac plug in patients with atrial fibrillation. Arq Bras Cardiol 98:528–536PubMedCrossRef Guérios EE, Schmid M, Gloekler S, Khattab AA, Wenaweser PM, Windecker S, Meier B (2012) Left atrial appendage closure with the Amplatzer cardiac plug in patients with atrial fibrillation. Arq Bras Cardiol 98:528–536PubMedCrossRef
7.
Zurück zum Zitat Lam YY, Yip GW, Yu CM, Chan WW, Cheng BC, Yan BP, Clugston R, Yong G, Gattorna T, Paul V (2012) Left atrial appendage closure with AMPLATZER cardiac plug for stroke prevention in atrial fibrillation: initial Asia–Pacific experience. Catheter Cardiovasc Interv 79:794–800PubMedCrossRef Lam YY, Yip GW, Yu CM, Chan WW, Cheng BC, Yan BP, Clugston R, Yong G, Gattorna T, Paul V (2012) Left atrial appendage closure with AMPLATZER cardiac plug for stroke prevention in atrial fibrillation: initial Asia–Pacific experience. Catheter Cardiovasc Interv 79:794–800PubMedCrossRef
8.
Zurück zum Zitat Cruz-Gonzalez I, Martín Moreiras J, García E (2011) Thrombus formation after left atrial appendage exclusion using an Amplatzer cardiac plug device. Catheter Cardiovasc Interv 78:970–973PubMedCrossRef Cruz-Gonzalez I, Martín Moreiras J, García E (2011) Thrombus formation after left atrial appendage exclusion using an Amplatzer cardiac plug device. Catheter Cardiovasc Interv 78:970–973PubMedCrossRef
9.
Zurück zum Zitat Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, Sievert H (2004) Incidence and clinical course of thrombus formation on atrial septal defect and patient foramen ovale closure devices in 1,000 consecutive patients. J Am Coll Cardiol 43:302–309PubMedCrossRef Krumsdorf U, Ostermayer S, Billinger K, Trepels T, Zadan E, Horvath K, Sievert H (2004) Incidence and clinical course of thrombus formation on atrial septal defect and patient foramen ovale closure devices in 1,000 consecutive patients. J Am Coll Cardiol 43:302–309PubMedCrossRef
10.
Zurück zum Zitat Ellenbogen KA, Wood MA, Shepard RK (2002) Delayed complications following pacemaker implantation. Pacing Clin Electrophysiol 25:1155–1158PubMedCrossRef Ellenbogen KA, Wood MA, Shepard RK (2002) Delayed complications following pacemaker implantation. Pacing Clin Electrophysiol 25:1155–1158PubMedCrossRef
11.
Zurück zum Zitat Aizawa K, Kaneko Y, Yamagishi T, Utsugi T, Suzuki T, Ishikawa S, Otaki A, Morishita Y, Hasegawa A, Kurabayashi M, Nagai R (2001) Oozing from the pericardium as an etiology of cardiac tamponade associated with screw-in atrial leads. Pacing Clin Electrophysiol 24:381–383PubMedCrossRef Aizawa K, Kaneko Y, Yamagishi T, Utsugi T, Suzuki T, Ishikawa S, Otaki A, Morishita Y, Hasegawa A, Kurabayashi M, Nagai R (2001) Oozing from the pericardium as an etiology of cardiac tamponade associated with screw-in atrial leads. Pacing Clin Electrophysiol 24:381–383PubMedCrossRef
12.
Zurück zum Zitat Landmesser U, Holmes DR Jr (2012) Left atrial appendage closure: a percutaneous transcatheter approach for stroke prevention in atrial fibrillation. Eur Heart J 33:698–704PubMedCrossRef Landmesser U, Holmes DR Jr (2012) Left atrial appendage closure: a percutaneous transcatheter approach for stroke prevention in atrial fibrillation. Eur Heart J 33:698–704PubMedCrossRef
13.
Zurück zum Zitat Rillig A, Schmidt B, Feige B, Wissner E, Metzner A, Arya A, Mathew S, Makimoto H, Wohlmuth P, Ouyang F, Kuck KH, Tilz RR (2013) Left atrial isthmus line ablation using a remote robotic navigation system: feasibility, efficacy and long-term outcome. Clin Res Cardiol 2013 Jul 30. [Epub ahead of print] Rillig A, Schmidt B, Feige B, Wissner E, Metzner A, Arya A, Mathew S, Makimoto H, Wohlmuth P, Ouyang F, Kuck KH, Tilz RR (2013) Left atrial isthmus line ablation using a remote robotic navigation system: feasibility, efficacy and long-term outcome. Clin Res Cardiol 2013 Jul 30. [Epub ahead of print]
14.
Zurück zum Zitat Chun KR, Schmidt B, Kuck KH, Andresen D, Willems S, Spitzer SG, Hoffmann E, Schumacher B, Eckardt L, Seidl K, Jünger C, Horack M, Brachmann J, Senges J (2013) Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry. Clin Res Cardiol 102:459–468PubMedCrossRef Chun KR, Schmidt B, Kuck KH, Andresen D, Willems S, Spitzer SG, Hoffmann E, Schumacher B, Eckardt L, Seidl K, Jünger C, Horack M, Brachmann J, Senges J (2013) Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry. Clin Res Cardiol 102:459–468PubMedCrossRef
Metadaten
Titel
Uncommon delayed and late complications after percutaneous left atrial appendage closure with Amplatzer® Cardiac Plug
verfasst von
Marco R. Schroeter
Bernhard C. Danner
Mark Hünlich
Wolfgang Schillinger
Publikationsdatum
01.04.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 4/2014
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-013-0648-0

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