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Intracardiac echocardiography off piste? Closure of the left atrial appendage using ICE and local anesthesia
Author(s) -
MacDonald Simon T.,
Newton James D.,
Ormerod Oliver J.
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22652
Subject(s) - medicine , left atrial appendage occlusion , intracardiac injection , occlusion , cardiology , fluoroscopy , atrial fibrillation , radiology , warfarin
Left atrial appendage (LAA) occlusion is increasingly accepted to reduce the risk of stroke in patients with atrial arrhythmia who are unsuitable for routine anticoagulation. It is generally performed under general anesthesia, guided by transoesophageal echocardiography with accurate imaging being essential for correct deployment of the device. We present a case where LAA occlusion was done under local anesthesia in a high‐anesthetic risk patient, using novel placement of an intracardiac echo probe via a Mullins sheath in the right ventricular outflow tract and pulmonary artery. This allowed accurate visualization of device deployment in the LAA. This technique may increase the spectrum of patients who may benefit from the procedure and decrease procedure time, fluoroscopy, and procedure‐related morbidity. © 2010 Wiley‐Liss, Inc.