Pulmonary Ridge Coverage: A Two-Edged Sword in Left Atrial Appendage Closure with LAmbre.

IF 5.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Canadian Journal of Cardiology Pub Date : 2025-02-13 DOI:10.1016/j.cjca.2025.02.018
Jiaxu Shen, Yanyan Chen, Liangguo Wang, Shengjie Wu, Hao Zhou, Zhouqing Huang, Yihe Chen, Xiangxiang Shi, Xiao Chen, Xinlei Wu, Jincheng Xing, Zixuan Wang, Fangyi Xiao
{"title":"Pulmonary Ridge Coverage: A Two-Edged Sword in Left Atrial Appendage Closure with LAmbre.","authors":"Jiaxu Shen, Yanyan Chen, Liangguo Wang, Shengjie Wu, Hao Zhou, Zhouqing Huang, Yihe Chen, Xiangxiang Shi, Xiao Chen, Xinlei Wu, Jincheng Xing, Zixuan Wang, Fangyi Xiao","doi":"10.1016/j.cjca.2025.02.018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The LAmbre occluder, available in two versions, allows for selective coverage of the pulmonary ridge (PR) during left atrial appendage closure (LAAC). This study evaluated the effects of PR coverage on imaging and clinical outcomes in patients undergoing LAAC.</p><p><strong>Methods: </strong>Imaging data and clinical events were retrospectively analyzed for patients with nonvalvular atrial fibrillation who successfully underwent LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University between October 2018 and May 2022. The primary composite endpoint was thromboembolic (TE) events and DRT.</p><p><strong>Results: </strong>In total, 259 patients were evaluated using transesophageal echocardiography (TEE) at a median interval of 52 days (short-term) and 385 days (long-term). Patients were divided into a PR-covered group (n=109) and a PR-uncovered group (n=150). PR-uncovered patients showed a trend toward higher DRT incidence (8/150 vs 1/109, P=0.056, log-rank test). The primary composite endpoint of TE events and DRT was significantly lower in the PR-covered group (14.0% vs 6.4%, P=0.046, log-rank test). Any peri-device leak (PDL) was more frequent in the PR-covered group during both short-term (45.9% vs 28.7%, P=0.004) and long-term follow-up (49.5% vs 25.3%, P<0.001), but no differences was found in significant PDLs (>3mm). PR coverage was identified as an independent predictor of long-term any PDL (odds ratio 3.19, 95% confidence interval 1.64-6.18, P<0.001).</p><p><strong>Conclusions: </strong>PR coverage during LAAC with the LAmbre device was associated with a reduced risk of the primary composite endpoint of TE events and DRT, albeit with an increased incidence of nonsignificant PDL (≤3mm).</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cjca.2025.02.018","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The LAmbre occluder, available in two versions, allows for selective coverage of the pulmonary ridge (PR) during left atrial appendage closure (LAAC). This study evaluated the effects of PR coverage on imaging and clinical outcomes in patients undergoing LAAC.

Methods: Imaging data and clinical events were retrospectively analyzed for patients with nonvalvular atrial fibrillation who successfully underwent LAAC using the LAmbre device at the First Affiliated Hospital of Wenzhou Medical University between October 2018 and May 2022. The primary composite endpoint was thromboembolic (TE) events and DRT.

Results: In total, 259 patients were evaluated using transesophageal echocardiography (TEE) at a median interval of 52 days (short-term) and 385 days (long-term). Patients were divided into a PR-covered group (n=109) and a PR-uncovered group (n=150). PR-uncovered patients showed a trend toward higher DRT incidence (8/150 vs 1/109, P=0.056, log-rank test). The primary composite endpoint of TE events and DRT was significantly lower in the PR-covered group (14.0% vs 6.4%, P=0.046, log-rank test). Any peri-device leak (PDL) was more frequent in the PR-covered group during both short-term (45.9% vs 28.7%, P=0.004) and long-term follow-up (49.5% vs 25.3%, P<0.001), but no differences was found in significant PDLs (>3mm). PR coverage was identified as an independent predictor of long-term any PDL (odds ratio 3.19, 95% confidence interval 1.64-6.18, P<0.001).

Conclusions: PR coverage during LAAC with the LAmbre device was associated with a reduced risk of the primary composite endpoint of TE events and DRT, albeit with an increased incidence of nonsignificant PDL (≤3mm).

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Canadian Journal of Cardiology
Canadian Journal of Cardiology 医学-心血管系统
CiteScore
9.20
自引率
8.10%
发文量
546
审稿时长
32 days
期刊介绍: The Canadian Journal of Cardiology (CJC) is the official journal of the Canadian Cardiovascular Society (CCS). The CJC is a vehicle for the international dissemination of new knowledge in cardiology and cardiovascular science, particularly serving as the major venue for Canadian cardiovascular medicine.
期刊最新文献
Mechanisms and Prognosis of Intolerance to Angiotensin Receptor Neprilysin Inhibitors in Advanced Heart Failure: Insights from Vasodilator Challenge. New Insights into Genetic Right Ventricular Cardiomyopathies. Pulmonary Ridge Coverage: A Two-Edged Sword in Left Atrial Appendage Closure with LAmbre. Integrative Omics Approaches in Cardiovascular Disease Research: Current Trends and Future Directions. Long-Term Outcomes of Fontan Patients with an Extracardiac Conduit: A Systematic Review and Meta-Analysis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1