Left Atrial Appendage Closure Guided by Integrated Echocardiography and Fluoroscopy Imaging Reduces Radiation ExposureReportar como inadecuado




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Aims

To investigate whether percutaneous left atrial appendage LAA closure guided by automated real-time integration of 2D-3D-transesophageal echocardiography TEE and fluoroscopy imaging results in decreased radiation exposure.

Methods and Results

In this open-label single-center study LAA closure AmplatzerTM Cardiac Plug was performed in 34 consecutive patients 8 women; 73.1±8.5 years with n = 17, EN+ or without n = 17, EN- integrated echocardiography-fluoroscopy imaging guidance EchoNavigator® EN; Philips Healthcare. There were no significant differences in baseline characteristics between both groups. Successful LAA closure was documented in all patients. Radiation dose was reduced in the EN+ group about 52% EN+: 48.5±30.7 vs. EN-: 93.9±64.4 Gy-cm2; p = 0.01. Corresponding to the radiation dose fluoroscopy time was reduced EN+: 16.7±7 vs. EN-: 24.0±11.4 min; p = 0.035. These advantages were not at the cost of increased procedure time 89.6±28.8 vs. 90.1±30.2 min; p = 0.96 or periprocedural complications. Contrast media amount was comparable between both groups 172.3±92.7 vs. 197.5±127.8 ml; p = 0.53. During short-term follow-up of at least 3 months mean: 8.1±5.9 months no device-related events occurred.

Conclusions

Automated real-time integration of echocardiography and fluoroscopy can be incorporated into procedural work-flow of percutaneous left atrial appendage closure without prolonging procedure time. This approach results in a relevant reduction of radiation exposure.

Trial Registration

ClinicalTrials.gov NCT01262508



Autor: Christiane Jungen , Tobias Zeus , Jan Balzer, Christian Eickholt, Margot Petersen, Eva Kehmeier, Verena Veulemans, Malte Kelm, St

Fuente: http://plos.srce.hr/



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