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Echocardiographic guidance and monitoring of left atrial appendage closure with AtriClip during open‐chest cardiac surgery
Author(s) -
Contri Rachele,
Clivio Sara,
Torre Tiziano,
Cassina Tiziano
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13697
Subject(s) - appendage , medicine , cardiac surgery , cardiology , closure (psychology) , atrial appendage , atrial fibrillation , anatomy , market economy , sinus rhythm , economics
Left atrial appendage ( LAA ) closure prevents thromboembolic risk and avoids lifelong anticoagulation due to atrial fibrillation ( AF ). Nowadays, AtriClip, a modern epicardial device approved in June 2010, allows external and safe closure of LAA in patients undergoing cardiac surgery during other open‐chest cardiac surgical procedures. Such a surgical approach and its epicardial deployment differentiates LAA closure with AtriClip from percutaneous closure techniques such as Watchman (Boston Scientific, Marlborough, MA, USA), Lariat (SentreHEART Inc., Redwood City, CA, USA), and Amplatzer Amulet (St. Jude Medical, St. Paul, MN, USA) device procedures. AtriClip positioning must consider perioperative transesophageal echocardiography ( TEE ) to confirm LAA anatomical features, to explore the links with neighboring structures, and finally to assess its successful closure. We report a sequence of images to document the role of intraoperative TEE during an elective aortic valve replacement and LAA external closure with AtriClip.

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