ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024
Computed tomography-based device-sizing in Amplatzer Amulet left atrial appendage occlusion.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Percutaneous Left Atrial Appendage Closure: Current Evidence and Procedural Insights.Reviews in cardiovascular medicine · 2025Review
- Preprocedural 3D Transesophageal Echocardiography for the Prediction of Device Deformation Morphology and Peri-Device Leaks After Transcatheter Left Atrial Appendage Occlusion with the AmplatzerJournal of clinical medicine · 2025Article
- A new implanter classification system for left atrial appendage closure from the European Left Atrial Appendage Closure Club (ELAACC).EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Imaging assessment after percutaneous left atrial appendage closure: from immediate to long-term follow-up.European heart journal. Cardiovascular Imaging · 2025Review
- 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
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAmplatzer Amulet is a frequently used device for left atrial appendage occlusion (LAAO). The current sizing protocol is based on the maximum diameter of the left atrial appendage (LAA) landing zone. However, mean, perimeter-, or area-derived diameter might be more accurate measures for device sizing.
methodsRetrospective analysis of 150 consecutive patients undergoing LAAO is guided by pre-procedural cardiac CT. A total of 117 patients were included; 7 were excluded due to renal failure and 26 due to closure with the sandwich technique. The maximum, mean, area-, and perimeter-derived diameters of the landing zone were derived from pre-procedural cardiac CT scans, and their accuracy to predict the implanted device size was investigated. The predicted device size was determined based on the currently recommended sizing algorithm. Peri-device leak (PDL) was assessed (grade 1-3) along with the underlying mechanism.
resultsDevice-sizing accuracy was superior for mean, area-, and perimeter derived diameters compared with the maximal diameter, especially for eccentric landing zones. Mean difference between predicted and actually implanted device size was 0.08 mm (± 2.77), 0.30 mm (± 2.40), - 0.39 mm (± 2.43), and - 2.55 mm (± 2.57) across mean, area-derived, perimeter-derived, and maximal diameter, respectively. Grade 3 peri-device leak was seen in 8.5% of implants without a significant association to the eccentricity of the landing zone. The leading mechanism for PDL was device malalignment.
conclusionOur results indicate mean, area-, and perimeter-derived diameters of the device landing zone to perform similar and superior in device-sizing accuracy compared with the maximum diameter.
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