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Initial Experience With Epicardial Left Atrial Appendage Ligation Using The Lariat Suture Closure Device | 16551
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
Open Access

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Initial experience with epicardial left atrial appendage ligation using the lariat suture closure device

4th International Conference on Clinical & Experimental Cardiology

Sheetal Chandhok and Antonis Pratsos

ScientificTracks Abstracts: J Clin Exp Cardiolog

DOI: 10.4172/2155-9880.S1.019

Abstract
Background: Atrial Fibrillation (AF) portends a progressively higher risk of embolic complications, reflected by a patient?s CHADS2-VA2SC score. Unfortunately many patients are unable or ineligible to take anticoagulation secondary to bleeding complications. Recently, the Lariat suture delivery device has become available to effectively deliver a single ligature around the left atrial appendage (LAA), with closure rates of 98% at 1 year. Methods: 21 patients (15M, 6F) Age 81?7 years, CHADS2-VA2SC of 4.5?1.2, with both persistent and paroxysmal AF underwent CT scanning of their LAA to evaluate their candidacy for the Lariat procedure.13/21 LAA?s were deemed adequate, and were offered the procedure. 7/13 patients refused the procedure, and 6 underwent LAA closure. One patient was discovered to have an anatomical variant which prevented transseptal puncture, so the procedure was aborted. The remaining 5 successfully underwent the Lariat procedure. Results: 8/21pts were unable to undergo the procedure secondary to their LAA anatomy. 5 LAA were behind the pulmonary artery, 2 were larger than 40mm, and 1 patient had pectusexcavatum. Immediate, complete closure was achieved in 5/5 patients without complications. 4/5 had TEE performed in 3 months with persistent complete occlusion of LAA. 2 patients had exacerbation of CHF as outpatients that required escalation of their diuretic therapy. Average procedure time was 94?20 mins and fluoroscopy time was 30.8?11 mins. No embolic complications have been observed in 171?115 Days of follow up. Conclusion: The Lariat suture closure device can completely close the LAA without significant procedural risk. A significant number of patients are currently excluded from undergoing the procedure secondary to LAA anatomy.
Biography
Sheetal Chandhok completed a 6 year accelerated BA/MD program at Lehigh University and MCP/Hahnemann Medial School. He completed residency at University of Pennsylvania and Cardiology and Electrophysiology at University of Pittsburgh. He has been practicing for 6 years at the Main Line Health System outside of Philadelphia, PA
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