"A bend in time": Shaping the sheath facilitates left atrial appendage closure. Issue 5 (23rd May 2015)

• Record Type: Journal Article
• Authors: Gafoor, Sameer; Heuer, Luisa; Schulz, Philipp; Matic, Predrag; Franke, Jennifer; Bertog, Stefan; Reinartz, Markus; Vaskelyte, Laura; Hofmann, Ilona; Sievert, Horst
• Is Part Of: Catheterization and cardiovascular interventions. Volume 86:Issue 5(2015:Nov. 01)
• Page Start: E224
• Page End: E228
• Publication Date: 2015-05-23
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25996
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25996-sec-0001" sec-type="section"> <title>Objectives</title> <p>The purpose of this study is to determine feasibility, safety, and effectiveness of the "shape‐the‐sheath" method in left atrial appendage closure.</p> </sec> <sec id="ccd25996-sec-0002" sec-type="section"> <title>Background</title> <p>LAA occlusion is often a difficult procedure, due to not just the learning curve but also the three‐dimensional variable nature of the left atrial appendage. Multiple sheaths have been created for various takeoffs. The purpose of this article is to show the feasibility of the "shape‐the‐sheath" method in left atrial appendage closure.</p> </sec> <sec id="ccd25996-sec-0003" sec-type="section"> <title>Methods</title> <p>Ten consecutive patients undergoing LAA occlusion without the "shape‐the‐sheath" method were compared to 10 consecutive patients undergoing LAA occlusion with the "shape‐the‐sheath" method using the Amplatzer Cardiac Plug (ACP) system and the Amplatzer TorqVue 45 × 45 sheath.</p> </sec> <sec id="ccd25996-sec-0004" sec-type="section"> <title>Results</title> <p>The "shape‐the‐sheath" method resulted in significant decreases in fluoroscopy time (7.2 ± 3.0 min vs. 13.7 ± 6.7 min, <italic>P</italic> < 0.05), number of partial recaptures (0% vs. 50%, <italic>P</italic> < 0.05), with a trend toward decrease in the number of complete recaptures (0 vs. 40%, <italic>P</italic> = 0.09) compared to conventional sheath use.</p> </sec> <sec id="ccd25996-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Shaping‐the‐sheath is a simple, elegant way to help conform delivery systems to better access the LAA and ensure stable position. Further experience with this procedure optimization step is warranted. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>