Evidence map›Paper›PMID 30548264›Full record

Observational studyClinical cardiology2019

Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography.

Simon Lindner, Michael Behnes, Annika Wenke, Benjamin Sartorius, Wulf Dieker, Uzair Ansari, Muharrem Akin, Thomas Bertsch, Kambis Mashayekhi, Nils Vogler and 4 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Pulmonary artery perforation after percutaneous left atrial appendage closure: two case reports and review of literature.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Review
  3. Article
  4. Observational
  5. Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Simon LindnerFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Michael BehnesFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.ORCID https://orcid.org/0000-0001-5970-0093
Annika WenkeFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Benjamin SartoriusFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Wulf DiekerFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Uzair AnsariFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Muharrem AkinDepartment of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Thomas BertschInstitute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany.
Kambis MashayekhiClinic for Cardiology and Angiology II, University Center Freiburg Bad Krozingen, University of Freiburg, Bad Krozingen, Germany.
Nils VoglerInstitute of Clinical Radiology, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
Holger HaubenreisserInstitute of Clinical Radiology, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
Stefan O SchoenbergInstitute of Clinical Radiology, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
Martin BorggrefeFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.
Ibrahim AkinFirst Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research), Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough left atrial appendage (LAA) anatomy and topographic relations are well understood, little is known about the impairment of neighboring structures (NBS) by an implanted left atrial appendage closure (LAAC) device. This prospective longitudinal observational study for the first time describes distances of implanted LAA closure (LAAC) devices to NBS using a standardized imaging protocol of cardiac computed tomography angiography (cCTA). HYPOTHESIS: cCTA imaging is an eligible tool for post-implantation evaluation of LAAC devices and their relation to neighboring structures.

methodscCTA data sets of consecutive patients 6 months after successful LAAC were acquired on a third generation dual-source CT system and reconstructed with a slice thickness of 0.5 mm. The standardized multi-planar reconstruction LAA occluder view for post-implantation evaluation (LOVE) algorithm was used to measure the distances to NBS in relation to LAA morphology and implanted LAAC devices.

resultsA total of 48 patients (median age 80 years, 25% female) were included. Left upper pulmonary vein and circumflex artery were generally closest to occlusion devices (median 2.9 and 2.8 mm, respectively). AMPLATZER AMULET devices were closer to the mitral valve annulus than WATCHMAN devices (6.6 mm (inter quartile range [IQR] 4.9-8.6) vs 10.9 mm (IQR 7.4-14.0), P = 0.001). Distances to the left upper pulmonary vein were affected by LAA morphology, with cauliflower type having the closest proximity (1.7 mm [IQR 1.0-3.4], P = 0.048).

conclusionA standardized cCTA imaging protocol is an eligible tool to accurately measure distances to NBS. Left upper pulmonary vein and circumflex artery are closest to LAAC devices and could thus be most prone to impairment.

Indexed as

AlgorithmsSeptal Occluder DeviceAgedAged, 80 and overAtrial AppendageAtrial FibrillationCardiac CatheterizationCardiac Surgical ProceduresComputed Tomography AngiographyEchocardiography, TransesophagealFemaleFollow-Up StudiesHumansMaleProspective Studiescardiac computed tomography angiographyleft atrial appendage closureLOVEneighboring structuresstandardized imaging protocol

Identifiers

PMID30548264
PMCPMC6712306

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.