A modified pigtail-only approach for left atrial appendage ligation achieved acute complete closure in 96.8% of patients, with complete closure maintained in 95.5% at 6 weeks to 3 months.
Observational (n=104)
Yes
Does a simplified, pigtail-only modified approach for percutaneous epicardial LAA ligation safely and effectively achieve LAA closure?
A simplified, pigtail-only approach for percutaneous epicardial LAA ligation using the LARIAT snare is feasible, safe, and achieves high rates of acute and short-term complete LAA closure.
BACKGROUND: Percutaneous epicardial left atrial appendage (LAA) ligation requires a series of steps and ancillary tools and is thus perceived as complex. OBJECTIVE: In this report, we evaluate the feasibility, safety, and effectiveness of a modified approach for LAA ligation. METHODS: This is a retrospective multicenter collection of patients who underwent a modified LAA ligation approach. Utilizing only a pigtail LAA angiogram, the LARIAT snare was guided over the pigtail catheter to perform LAA ligation. Periprocedural and 30-day adverse events were collected. Follow-up imaging was performed six weeks to three months post-ligation to assess for leaks. RESULTS: Twenty-one centers enrolled 104 patients (aged 71.7±7.2 years; 70% male) who underwent attempted modified LAA ligation. Acute complete LAA closure was achieved in 96.8% (91/94) of patients. LAA ligation failed in 8 patients due to adhesions. Two patients could not be ligated with the modified pigtail approach and were converted to magnet wires, with one successful and one unsuccessful LAA ligation. The failed LAA ligation was due to a perforation of the magnet wires. There were no peri-procedural complications (3 mm were observed. CONCLUSION: The evolution of the pigtail-only modified LAA ligation approach is feasible, safe, and effective at LAA closure. Future studies are still needed to assess the long-term LAA closure efficacy of this modified LAA ligation approach.
Grossi et al. (Fri,) conducted a observational in Patients requiring left atrial appendage ligation (n=104). Modified pigtail-only LAA ligation approach was evaluated on Acute complete LAA closure. A modified pigtail-only approach for left atrial appendage ligation achieved acute complete closure in 96.8% of patients, with complete closure maintained in 95.5% at 6 weeks to 3 months.