ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2021
Prevalence, mechanisms and impact of residual patency and device-related thrombosis following left atrial appendage occlusion: a computed tomography analysis.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- Mechanisms, predictors, and evolution of severe peri-device leaks with two different left atrial appendage occluders.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Trial
- Left Atrial Appendage Electrical Isolation Reduces Residual Patency After Device Closure in Patients With Persistent Atrial Fibrillation.Journal of the American Heart Association · 2026Article
- Incidence and Predictors of Hypoattenuated Thickening and Device-Related Thrombus at Three Months Postprocedural CT Assessment Following Left Atrial Appendage Occlusion With Amplatzer Devices-A Single-Center Cohort.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Left atrial appendage closure with a novel nonpacifier device for stroke prevention in atrial fibrillation.Scientific reports · 2026Article
- Imaging assessment after percutaneous left atrial appendage closure: from immediate to long-term follow-up.European heart journal. Cardiovascular Imaging · 2025Review
- Risk factors of incomplete endothelialization after left atrial appendage occlusion in patients with atrial fibrillation.Archives of medical science : AMS · 2025Article
- Peri-device leakage and delayed endothelialization of the Watchman device: a computed tomography study.European radiology · 2024Article
- Clinical incidence and relevance of incomplete endothelialization in atrial fibrillation patients with Left Atrial Appendage Closure.BMC cardiovascular disorders · 2024Article
- Long-term cardiac computed tomography follow-up after left atrial appendage occlusion.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Observational
- Single antiplatelet therapy following Amplatzer left atrial appendage occlusion.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Observational
- The role of CT in arrhythmia management-treatment planning and post-procedural imaging surveillance.The British journal of radiology · 2023Review
- Outcomes of cardiac surgery with left atrial appendage occlusion versus no Occlusion, direct oral Anticoagulants, and vitamin K Antagonists: A systematic review with Meta-analysis.International journal of cardiology. Heart & vasculature · 2022Review
- Role of computed tomography in transcatheter coronary and structural heart disease interventions.REC, interventional cardiologyArticle
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiac computed tomography angiography (CCTA) appears to be an appropriate imaging technique for device surveillance after left atrial appendage occlusion (LAAO). However, the available experience is limited.
aimsThe aim of this study was to determine the prevalence, mechanisms and clinical impact of left atrial appendage (LAA) patency and device-related thrombosis (DRT) following LAAO utilising a novel CCTA-based classification.
methodsConsecutively enrolled patients who underwent LAAO with an AMPLATZER device were followed up with CCTA. Mechanisms and frequency of residual patency were evaluated and correlated with clinical events. Atrial-side device thrombus, device positioning and presence of signs of device stability were also analysed.
resultsA total of 137 patients were included. LAA patency was observed in 56.9% (n=78). Mechanisms and frequency of patency were: malapposition of proximal segment of the device lobe (55.1%), peri-device leak (PDL, 34.6%) and fabric permeability (5.8%). Lobe-LAA axis misalignment was the only independent predictor of device patency after LAAO (HR 38.3, 95% CI: 13.6-107.0; p<0.001). After a median follow-up of 638 days, patency was not associated with an increased risk of death (all-cause or cardiovascular death) or cerebral/peripheral embolism regardless of its mechanism. Any degree of hypo-attenuated thickening (HAT) was found in 16.8% (n=23) of patients, of whom 16 (11.7%) had low-grade HAT and 7 (5.1%) had high-grade HAT or definite DRT. Complete sealing was associated with increased rates of low-grade HAT.
conclusionsLAA patency on CCTA follow-up is a frequent phenomenon due to malapposition of the proximal segment of the device lobe, PDL or fabric permeability. Patency was not associated with adverse outcomes. Low-grade HAT may be related to a benign, uneventful, endothelialisation process favoured by complete LAAO.
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