Percutaneous left atrial appendage closure using the TrueFusion™ fusion-imaging technology
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To describe percutaneous left atrial appendage closure (LAAc) in a patient with recurrent gastric ulcer bleeding with the help of the TrueFusion™ fusion-imaging system.
Method and results
In a patient with paroxysmal atrial fibrillation, the need for an effective oral anticoagulation and recurrent gastrointestinal bleeding, left atrial appendage closure (LAAc) was performed under guidance of the TrueFusion™ fusion-imaging technology (Siemens Healthineers, Erlangen, Germany) to enhance procedural precision, save radiation time and contrast dye. Left atrial appendage closure was performed with the use of a 20 mm Amplatzer Amulet™ (Abbott Laboratories, Chicago, IL, USA) using the TrueFusion™ system under mild sedation with minimal use of contrast. Intraprocedural transesophageal echocardiography revealed complete LAA occlusion without residual flow. The patient was uneventfully discharged on the second postoperative day.
LAAc using an integrated approach combining ultrasound and live fluoroscopy, as provided by the TrueFusion™, is safe and feasible. Target-oriented device navigation and synchronized image orientation as provided by fusion imaging may potentially be beneficial regarding radiation time, contrast dye and periprocedural risk of suboptimal device positioning.
KeywordsLeft atrial appendage closure Stroke Anticoagulation LAA
Compliance with ethical standards
Conflict of interest
There are no conflicts of interest.
- 4.Sedaghat A, Vij V, Streit SR, Schrickel JW, Al-Kassou B, Nelles D, Kleinecke C, Windecker S, Meier B, Valglimigli M, Nietlispach F, Nickenig G, Gloekler S (2019) Incidence, predictors, and relevance of acute kidney injury in patients undergoing left atrial appendage closure with Amplatzer occluders: a multicentre observational study. Clin Res Cardiol. https://doi.org/10.1007/s00392-019-01524-9 CrossRefPubMedGoogle Scholar
- 5.Fink T, Schluter M, Tilz RR, Heeger CH, Lemes C, Maurer T, Reissmann B, Rottner L, Santoro F, Mathew S, Rillig A, Ouyang F, Kuck KH, Metzner A (2018) Acute and long-term outcomes of epicardial left atrial appendage ligation with the second-generation LARIAT device: a high-volume electrophysiology center experience. Clin Res Cardiol 107:1139–1147CrossRefGoogle Scholar
- 6.Hell MM, Achenbach S, Yoo IS, Franke J, Blachutzik F, Roether J, Graf V, Raaz-Schrauder D, Marwan M, Schlundt C (2017) 3D printing for sizing left atrial appendage closure device: head-to-head comparison with computed tomography and transoesophageal echocardiography. EuroIntervention 13:1234–1241CrossRefGoogle Scholar
- 9.Yazdani KO, Mitomo S, Ruparelia N, Candilio L, Giannini F, Jabbour RJ, Regazzoli D, Mazzone P, Stella S, Sora N, Montorfano M, Colombo A, Latib A (2019) Percutaneous left atrial appendage occlusion with the Amulet device: the impact of device disc position upon periprocedural and long-term outcomes. Catheter Cardiovasc Interv 93:120–127CrossRefGoogle Scholar