A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA
The WATCHMAN left atrial appendage (LAA) occlusion device has emerged as an alternative for anticoagulation in patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation therapy. Cardiac computed tomography (CTA) is increasingly being utilized to guide WATCHMAN device si...
Gespeichert in:
| Veröffentlicht in: | Cardiovascular revascularization medicine 2021-12, Vol.33, p.13-19 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 19 |
|---|---|
| container_issue | |
| container_start_page | 13 |
| container_title | Cardiovascular revascularization medicine |
| container_volume | 33 |
| creator | Nadeem, Fahd Igwe, Chinedu Stoycos, Stephen Jaswaney, Rahul Tsushima, Takahiro Al-Kindi, Sadeer Bansal, Eric Fares, Anas Dallan, Luis Patel, Sandeep Rajagopalan, Sanjay Arruda, Mauricio Filby, Steven Bezerra, Hiram |
| description | The WATCHMAN left atrial appendage (LAA) occlusion device has emerged as an alternative for anticoagulation in patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation therapy. Cardiac computed tomography (CTA) is increasingly being utilized to guide WATCHMAN device sizing, however no consensus algorithm exists. We present our experience with a new cardiac CTA LAA ostium area based sizing algorithm.
This is a single center, prospective study analyzing consecutive patients who underwent cardiac CTA and WATCHMAN device implantation between March 2017 and October 2019 at University Hospitals Cleveland Medical Center. Patients baseline characteristics, procedural data, and clinical outcomes were collected and analyzed.
115 patients were included in our study. The mean age of our population was 76.5 years ±8.3 years. 70.4% of our patients had preserved ejection fraction. The predominant indication for device implantation was gastrointestinal bleeding in 57.4% of patients. The mean CHADSVASC score was 4.68 ± 1.4. The procedure success rate was 99.1% and the mean number of device used per case of 1.15 ± 0.4 devices. Our CTA LAA ostium area based sizing algorithm accurately predicted the final deployed WATCHMAN device size in 95.6% of cases.
Our study demonstrates that cardiac CTA LAA ostium area based sizing algorithm is highly accurate at predicting WATCHMAN device size and demonstrates excellent clinical outcomes with lower device utilization per case than what is reported in literature.
•Cardiac computed tomography is increasingly being utilized to guide WATCHMAN device sizing, with no consensus algorithm•Left atrial appendage ostium area measured by cardiac computed tomography is highly accurate for WATCHMAN device sizing |
| doi_str_mv | 10.1016/j.carrev.2021.01.009 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2485519647</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1553838921000129</els_id><sourcerecordid>2485519647</sourcerecordid><originalsourceid>FETCH-LOGICAL-c362t-b5ba5019b590a35a25a6ca4961f5e9d14e4891e4ed7c6c8233b96415d41e1b003</originalsourceid><addsrcrecordid>eNp9kE1Lw0AQhhdRbK3-A5EcvSTuR3aTvQih-AW1HmzxuGw207olaepuWtFf75ZUj8LADMM78848CF0SnBBMxM0qMdo52CUUU5LgEFgeoSHJszzGkuXHoeacxTnL5QCdeb_CmGVUZKdowBingkk6RLyIpvAZvRWz8eNzMY1e7bddL6OiXrbOdu9NNO9s3ffG2lVWm2g8K87RyULXHi4OeYTm93dhQzx5eXgaF5PYMEG7uOSl5pjIkkusGdeUa2F0KgVZcJAVSSHNJYEUqswIk1PGSilSwquUACnDuSN03e_duPZjC75TjfUG6lqvod16RdOccxJmsiBNe6lxrfcOFmrjbKPdlyJY7YGpleqBqT0whUMETCN0dXDYlg1Uf0O_hILgthdA-HNnwSlvLKwNVNaB6VTV2v8dfgBIT3rI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2485519647</pqid></control><display><type>article</type><title>A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Nadeem, Fahd ; Igwe, Chinedu ; Stoycos, Stephen ; Jaswaney, Rahul ; Tsushima, Takahiro ; Al-Kindi, Sadeer ; Bansal, Eric ; Fares, Anas ; Dallan, Luis ; Patel, Sandeep ; Rajagopalan, Sanjay ; Arruda, Mauricio ; Filby, Steven ; Bezerra, Hiram</creator><creatorcontrib>Nadeem, Fahd ; Igwe, Chinedu ; Stoycos, Stephen ; Jaswaney, Rahul ; Tsushima, Takahiro ; Al-Kindi, Sadeer ; Bansal, Eric ; Fares, Anas ; Dallan, Luis ; Patel, Sandeep ; Rajagopalan, Sanjay ; Arruda, Mauricio ; Filby, Steven ; Bezerra, Hiram</creatorcontrib><description>The WATCHMAN left atrial appendage (LAA) occlusion device has emerged as an alternative for anticoagulation in patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation therapy. Cardiac computed tomography (CTA) is increasingly being utilized to guide WATCHMAN device sizing, however no consensus algorithm exists. We present our experience with a new cardiac CTA LAA ostium area based sizing algorithm.
This is a single center, prospective study analyzing consecutive patients who underwent cardiac CTA and WATCHMAN device implantation between March 2017 and October 2019 at University Hospitals Cleveland Medical Center. Patients baseline characteristics, procedural data, and clinical outcomes were collected and analyzed.
115 patients were included in our study. The mean age of our population was 76.5 years ±8.3 years. 70.4% of our patients had preserved ejection fraction. The predominant indication for device implantation was gastrointestinal bleeding in 57.4% of patients. The mean CHADSVASC score was 4.68 ± 1.4. The procedure success rate was 99.1% and the mean number of device used per case of 1.15 ± 0.4 devices. Our CTA LAA ostium area based sizing algorithm accurately predicted the final deployed WATCHMAN device size in 95.6% of cases.
Our study demonstrates that cardiac CTA LAA ostium area based sizing algorithm is highly accurate at predicting WATCHMAN device size and demonstrates excellent clinical outcomes with lower device utilization per case than what is reported in literature.
•Cardiac computed tomography is increasingly being utilized to guide WATCHMAN device sizing, with no consensus algorithm•Left atrial appendage ostium area measured by cardiac computed tomography is highly accurate for WATCHMAN device sizing</description><identifier>ISSN: 1553-8389</identifier><identifier>EISSN: 1878-0938</identifier><identifier>DOI: 10.1016/j.carrev.2021.01.009</identifier><identifier>PMID: 33526392</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Algorithms ; Atrial Appendage - diagnostic imaging ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - therapy ; Cardiac Catheterization ; Device sizing ; Echocardiography, Transesophageal ; Humans ; Left atrial appendage closure ; Prospective Studies ; Stroke ; Tomography ; Treatment Outcome ; WATCHMAN device</subject><ispartof>Cardiovascular revascularization medicine, 2021-12, Vol.33, p.13-19</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-b5ba5019b590a35a25a6ca4961f5e9d14e4891e4ed7c6c8233b96415d41e1b003</citedby><cites>FETCH-LOGICAL-c362t-b5ba5019b590a35a25a6ca4961f5e9d14e4891e4ed7c6c8233b96415d41e1b003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.carrev.2021.01.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33526392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nadeem, Fahd</creatorcontrib><creatorcontrib>Igwe, Chinedu</creatorcontrib><creatorcontrib>Stoycos, Stephen</creatorcontrib><creatorcontrib>Jaswaney, Rahul</creatorcontrib><creatorcontrib>Tsushima, Takahiro</creatorcontrib><creatorcontrib>Al-Kindi, Sadeer</creatorcontrib><creatorcontrib>Bansal, Eric</creatorcontrib><creatorcontrib>Fares, Anas</creatorcontrib><creatorcontrib>Dallan, Luis</creatorcontrib><creatorcontrib>Patel, Sandeep</creatorcontrib><creatorcontrib>Rajagopalan, Sanjay</creatorcontrib><creatorcontrib>Arruda, Mauricio</creatorcontrib><creatorcontrib>Filby, Steven</creatorcontrib><creatorcontrib>Bezerra, Hiram</creatorcontrib><title>A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA</title><title>Cardiovascular revascularization medicine</title><addtitle>Cardiovasc Revasc Med</addtitle><description>The WATCHMAN left atrial appendage (LAA) occlusion device has emerged as an alternative for anticoagulation in patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation therapy. Cardiac computed tomography (CTA) is increasingly being utilized to guide WATCHMAN device sizing, however no consensus algorithm exists. We present our experience with a new cardiac CTA LAA ostium area based sizing algorithm.
This is a single center, prospective study analyzing consecutive patients who underwent cardiac CTA and WATCHMAN device implantation between March 2017 and October 2019 at University Hospitals Cleveland Medical Center. Patients baseline characteristics, procedural data, and clinical outcomes were collected and analyzed.
115 patients were included in our study. The mean age of our population was 76.5 years ±8.3 years. 70.4% of our patients had preserved ejection fraction. The predominant indication for device implantation was gastrointestinal bleeding in 57.4% of patients. The mean CHADSVASC score was 4.68 ± 1.4. The procedure success rate was 99.1% and the mean number of device used per case of 1.15 ± 0.4 devices. Our CTA LAA ostium area based sizing algorithm accurately predicted the final deployed WATCHMAN device size in 95.6% of cases.
Our study demonstrates that cardiac CTA LAA ostium area based sizing algorithm is highly accurate at predicting WATCHMAN device size and demonstrates excellent clinical outcomes with lower device utilization per case than what is reported in literature.
•Cardiac computed tomography is increasingly being utilized to guide WATCHMAN device sizing, with no consensus algorithm•Left atrial appendage ostium area measured by cardiac computed tomography is highly accurate for WATCHMAN device sizing</description><subject>Aged</subject><subject>Algorithms</subject><subject>Atrial Appendage - diagnostic imaging</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - therapy</subject><subject>Cardiac Catheterization</subject><subject>Device sizing</subject><subject>Echocardiography, Transesophageal</subject><subject>Humans</subject><subject>Left atrial appendage closure</subject><subject>Prospective Studies</subject><subject>Stroke</subject><subject>Tomography</subject><subject>Treatment Outcome</subject><subject>WATCHMAN device</subject><issn>1553-8389</issn><issn>1878-0938</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQhhdRbK3-A5EcvSTuR3aTvQih-AW1HmzxuGw207olaepuWtFf75ZUj8LADMM78848CF0SnBBMxM0qMdo52CUUU5LgEFgeoSHJszzGkuXHoeacxTnL5QCdeb_CmGVUZKdowBingkk6RLyIpvAZvRWz8eNzMY1e7bddL6OiXrbOdu9NNO9s3ffG2lVWm2g8K87RyULXHi4OeYTm93dhQzx5eXgaF5PYMEG7uOSl5pjIkkusGdeUa2F0KgVZcJAVSSHNJYEUqswIk1PGSilSwquUACnDuSN03e_duPZjC75TjfUG6lqvod16RdOccxJmsiBNe6lxrfcOFmrjbKPdlyJY7YGpleqBqT0whUMETCN0dXDYlg1Uf0O_hILgthdA-HNnwSlvLKwNVNaB6VTV2v8dfgBIT3rI</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Nadeem, Fahd</creator><creator>Igwe, Chinedu</creator><creator>Stoycos, Stephen</creator><creator>Jaswaney, Rahul</creator><creator>Tsushima, Takahiro</creator><creator>Al-Kindi, Sadeer</creator><creator>Bansal, Eric</creator><creator>Fares, Anas</creator><creator>Dallan, Luis</creator><creator>Patel, Sandeep</creator><creator>Rajagopalan, Sanjay</creator><creator>Arruda, Mauricio</creator><creator>Filby, Steven</creator><creator>Bezerra, Hiram</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA</title><author>Nadeem, Fahd ; Igwe, Chinedu ; Stoycos, Stephen ; Jaswaney, Rahul ; Tsushima, Takahiro ; Al-Kindi, Sadeer ; Bansal, Eric ; Fares, Anas ; Dallan, Luis ; Patel, Sandeep ; Rajagopalan, Sanjay ; Arruda, Mauricio ; Filby, Steven ; Bezerra, Hiram</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-b5ba5019b590a35a25a6ca4961f5e9d14e4891e4ed7c6c8233b96415d41e1b003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Algorithms</topic><topic>Atrial Appendage - diagnostic imaging</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - therapy</topic><topic>Cardiac Catheterization</topic><topic>Device sizing</topic><topic>Echocardiography, Transesophageal</topic><topic>Humans</topic><topic>Left atrial appendage closure</topic><topic>Prospective Studies</topic><topic>Stroke</topic><topic>Tomography</topic><topic>Treatment Outcome</topic><topic>WATCHMAN device</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nadeem, Fahd</creatorcontrib><creatorcontrib>Igwe, Chinedu</creatorcontrib><creatorcontrib>Stoycos, Stephen</creatorcontrib><creatorcontrib>Jaswaney, Rahul</creatorcontrib><creatorcontrib>Tsushima, Takahiro</creatorcontrib><creatorcontrib>Al-Kindi, Sadeer</creatorcontrib><creatorcontrib>Bansal, Eric</creatorcontrib><creatorcontrib>Fares, Anas</creatorcontrib><creatorcontrib>Dallan, Luis</creatorcontrib><creatorcontrib>Patel, Sandeep</creatorcontrib><creatorcontrib>Rajagopalan, Sanjay</creatorcontrib><creatorcontrib>Arruda, Mauricio</creatorcontrib><creatorcontrib>Filby, Steven</creatorcontrib><creatorcontrib>Bezerra, Hiram</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular revascularization medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nadeem, Fahd</au><au>Igwe, Chinedu</au><au>Stoycos, Stephen</au><au>Jaswaney, Rahul</au><au>Tsushima, Takahiro</au><au>Al-Kindi, Sadeer</au><au>Bansal, Eric</au><au>Fares, Anas</au><au>Dallan, Luis</au><au>Patel, Sandeep</au><au>Rajagopalan, Sanjay</au><au>Arruda, Mauricio</au><au>Filby, Steven</au><au>Bezerra, Hiram</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA</atitle><jtitle>Cardiovascular revascularization medicine</jtitle><addtitle>Cardiovasc Revasc Med</addtitle><date>2021-12</date><risdate>2021</risdate><volume>33</volume><spage>13</spage><epage>19</epage><pages>13-19</pages><issn>1553-8389</issn><eissn>1878-0938</eissn><abstract>The WATCHMAN left atrial appendage (LAA) occlusion device has emerged as an alternative for anticoagulation in patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation therapy. Cardiac computed tomography (CTA) is increasingly being utilized to guide WATCHMAN device sizing, however no consensus algorithm exists. We present our experience with a new cardiac CTA LAA ostium area based sizing algorithm.
This is a single center, prospective study analyzing consecutive patients who underwent cardiac CTA and WATCHMAN device implantation between March 2017 and October 2019 at University Hospitals Cleveland Medical Center. Patients baseline characteristics, procedural data, and clinical outcomes were collected and analyzed.
115 patients were included in our study. The mean age of our population was 76.5 years ±8.3 years. 70.4% of our patients had preserved ejection fraction. The predominant indication for device implantation was gastrointestinal bleeding in 57.4% of patients. The mean CHADSVASC score was 4.68 ± 1.4. The procedure success rate was 99.1% and the mean number of device used per case of 1.15 ± 0.4 devices. Our CTA LAA ostium area based sizing algorithm accurately predicted the final deployed WATCHMAN device size in 95.6% of cases.
Our study demonstrates that cardiac CTA LAA ostium area based sizing algorithm is highly accurate at predicting WATCHMAN device size and demonstrates excellent clinical outcomes with lower device utilization per case than what is reported in literature.
•Cardiac computed tomography is increasingly being utilized to guide WATCHMAN device sizing, with no consensus algorithm•Left atrial appendage ostium area measured by cardiac computed tomography is highly accurate for WATCHMAN device sizing</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33526392</pmid><doi>10.1016/j.carrev.2021.01.009</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1553-8389 |
| ispartof | Cardiovascular revascularization medicine, 2021-12, Vol.33, p.13-19 |
| issn | 1553-8389 1878-0938 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2485519647 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Algorithms Atrial Appendage - diagnostic imaging Atrial Fibrillation - complications Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - therapy Cardiac Catheterization Device sizing Echocardiography, Transesophageal Humans Left atrial appendage closure Prospective Studies Stroke Tomography Treatment Outcome WATCHMAN device |
| title | A New WATCHMAN Sizing Algorithm Utilizing Cardiac CTA |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T16%3A48%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20New%20WATCHMAN%20Sizing%20Algorithm%20Utilizing%20Cardiac%20CTA&rft.jtitle=Cardiovascular%20revascularization%20medicine&rft.au=Nadeem,%20Fahd&rft.date=2021-12&rft.volume=33&rft.spage=13&rft.epage=19&rft.pages=13-19&rft.issn=1553-8389&rft.eissn=1878-0938&rft_id=info:doi/10.1016/j.carrev.2021.01.009&rft_dat=%3Cproquest_cross%3E2485519647%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2485519647&rft_id=info:pmid/33526392&rft_els_id=S1553838921000129&rfr_iscdi=true |