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- W4313312742 abstract "A giant left atrial appendage (LAA) is a rare source of recurrent cardioembolism. While there is no standard treatment for this condition, surgical resection is the most widespread therapy. Percutaneous closure can be considered but is challenging in extremely large LAA due to the inadequate size of current devices. We report a large LAA that was successfully closed percutaneously using a Lambre Closure System (Lifetech Scientific Corp.). A 75-year-old female with permanent atrial fibrillation and mechanical mitral prosthesis was referred for LAA closure due to several episodes of ischaemic stroke (CHAD2VASc = 6) despite correct oral anticoagulation and well-functioning mitral prosthesis. Transoesophageal echocardiography (TEE) demonstrated a large single-lobe LAA. The measures were 37×39mm at the level of the landing zone and 37×43mm at the ostium (Panel 1A). Cardiac computed tomography (CT) scan confirmed a giant LAA that cannot be occluded by the currently approved LAA closure devices. The working imaging plane to display the ostium of the LAA was seen in 33° right–anterior–oblique and craneo 10° projections. LAA 3D model of this case based on TEE and CT was printed out to verify the optimal device and the strategy for this challenging case (Panel 2, 3). The manufacturer custom-made a Lambre 40/44 mm (lobe/disc) device to fit this patient's LAA according to her CT. After advance 10 Fr delivery sheath, the 40− to 44-mm LAmbre device was advanced into the LAA. The umbrella (*) and after the cover (^) were successfully deployed, without residual leaks. Postprocedural 3D TEE confirmed optimal disc apposition and complete LAA ostia sealing (Panels 4A–D)." @default.
- W4313312742 created "2023-01-06" @default.
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- W4313312742 date "2022-12-30" @default.
- W4313312742 modified "2023-10-09" @default.
- W4313312742 title "No matter how big it is: 3D tools for giant atrial appendage closure" @default.
- W4313312742 doi "https://doi.org/10.1093/ehjci/jeac257" @default.
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