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Department of Clinical Medicine

Jesper Møller Jensen

Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet. / Freixa, Xavier; Cepas-Guillén, Pedro; Korsholm, Kasper et al.
In: Catheterization and Cardiovascular Interventions, Vol. 100, No. 5, 11.2022, p. 801-809.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Harvard

Freixa, X, Cepas-Guillén, P, Korsholm, K , Kramer, A, Regueiro, A, Flores-Umanzor, E, Sanchis, L, Arenas-Loriente, A, Jensen, JM & Nielsen-Kudsk, JE 2022, 'Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet', Catheterization and Cardiovascular Interventions, vol. 100, no. 5, pp. 801-809. https://doi.org/10.1002/ccd.30406

Vancouver

Freixa X, Cepas-Guillén P, Korsholm K , Kramer A, Regueiro A, Flores-Umanzor E et al. Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet. Catheterization and Cardiovascular Interventions. 2022 Nov;100(5):801-809. Epub 2022 Sept 24. doi: 10.1002/ccd.30406

Author

Freixa, Xavier ; Cepas-Guillén, Pedro ; Korsholm, Kasper et al. / Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet. In: Catheterization and Cardiovascular Interventions. 2022 ; Vol. 100, No. 5. pp. 801-809.

Bibtex

@article{eab659fba4364ca7b0e4cf606dd8ab7c,

title = "Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet",

abstract = "PURPOSE: The present article aims to compare a novel sizing chart based on both maximum and minimum diameters (novel MATRIX) with the current sizing recommendation instructions for use (IFU) based on the maximum diameter.BACKGROUND: Current IFU with the Amulet device are still based on the maximum left atrial appendage (LAA) diameter, which might lead to inappropriate oversizing, especially in elliptic appendages.METHODS: This was a retrospective analysis of patients undergoing LAA occlusion in two high-volume centers. Two hundred patients were included (100 patients with baseline cardiac computed tomography angiography [CCTA] and 100 with baseline 2D and 3D-transesophageal echocardiography [TEE]). The degree of concordance between the predicted device size recommendation and the actual device selection was the primary outcome.RESULTS: The novel MATRIX showed a higher level of concordance between the predicted and implanted device size, regardless of imaging modalities. CCTA showed the strongest, and 2D-TEE the weakest concordance between the predicted and implanted device for both MATRIX and IFU charts. The percentage of patients in whom the disagreement among the predicted and implanted device represented >1 size was higher when using the IFU chart. In elliptical LAA anatomies, the differences favoring the use of MATRIX compared to the IFU in terms of predicted/implanted agreement were higher. Finally, no significant differences in clinical or imaging endpoints were observed between the two different sizing charts.CONCLUSIONS: Incorporating both the LAA maximum and minimum diameters, as opposed to just maximum diameter, appears to improve sizing accuracy. The proposed MATRIX sizing chart offered a higher level of concordance between predicted and implanted device compared to the current IFU.",

keywords = "Atrial Appendage/diagnostic imaging, Atrial Fibrillation/diagnostic imaging, Cardiac Catheterization/adverse effects, Echocardiography, Transesophageal, Humans, Retrospective Studies, Treatment Outcome",

author = "Xavier Freixa and Pedro Cepas-Guill{\'e}n and Kasper Korsholm and Anders Kramer and Ander Regueiro and Eduardo Flores-Umanzor and Laura Sanchis and Andrea Arenas-Loriente and Jensen, {Jesper M{\o}ller} and Nielsen-Kudsk, {Jens Erik}",

note = "{\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2022",

month = nov,

doi = "10.1002/ccd.30406",

language = "English",

volume = "100",

pages = "801--809",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "JohnWiley & Sons, Inc.",

number = "5",

}

RIS

TY - JOUR

T1 - Usefulness of a novel sizing chart for left atrial appendage occlusion with the Amplatzer Amulet

AU - Freixa, Xavier

AU - Cepas-Guillén, Pedro

AU - Korsholm, Kasper

AU - Kramer, Anders

AU - Regueiro, Ander

AU - Flores-Umanzor, Eduardo

AU - Sanchis, Laura

AU - Arenas-Loriente, Andrea

AU - Jensen, Jesper Møller

AU - Nielsen-Kudsk, Jens Erik

PY - 2022/11

Y1 - 2022/11

N2 - PURPOSE: The present article aims to compare a novel sizing chart based on both maximum and minimum diameters (novel MATRIX) with the current sizing recommendation instructions for use (IFU) based on the maximum diameter.BACKGROUND: Current IFU with the Amulet device are still based on the maximum left atrial appendage (LAA) diameter, which might lead to inappropriate oversizing, especially in elliptic appendages.METHODS: This was a retrospective analysis of patients undergoing LAA occlusion in two high-volume centers. Two hundred patients were included (100 patients with baseline cardiac computed tomography angiography [CCTA] and 100 with baseline 2D and 3D-transesophageal echocardiography [TEE]). The degree of concordance between the predicted device size recommendation and the actual device selection was the primary outcome.RESULTS: The novel MATRIX showed a higher level of concordance between the predicted and implanted device size, regardless of imaging modalities. CCTA showed the strongest, and 2D-TEE the weakest concordance between the predicted and implanted device for both MATRIX and IFU charts. The percentage of patients in whom the disagreement among the predicted and implanted device represented >1 size was higher when using the IFU chart. In elliptical LAA anatomies, the differences favoring the use of MATRIX compared to the IFU in terms of predicted/implanted agreement were higher. Finally, no significant differences in clinical or imaging endpoints were observed between the two different sizing charts.CONCLUSIONS: Incorporating both the LAA maximum and minimum diameters, as opposed to just maximum diameter, appears to improve sizing accuracy. The proposed MATRIX sizing chart offered a higher level of concordance between predicted and implanted device compared to the current IFU.

AB - PURPOSE: The present article aims to compare a novel sizing chart based on both maximum and minimum diameters (novel MATRIX) with the current sizing recommendation instructions for use (IFU) based on the maximum diameter.BACKGROUND: Current IFU with the Amulet device are still based on the maximum left atrial appendage (LAA) diameter, which might lead to inappropriate oversizing, especially in elliptic appendages.METHODS: This was a retrospective analysis of patients undergoing LAA occlusion in two high-volume centers. Two hundred patients were included (100 patients with baseline cardiac computed tomography angiography [CCTA] and 100 with baseline 2D and 3D-transesophageal echocardiography [TEE]). The degree of concordance between the predicted device size recommendation and the actual device selection was the primary outcome.RESULTS: The novel MATRIX showed a higher level of concordance between the predicted and implanted device size, regardless of imaging modalities. CCTA showed the strongest, and 2D-TEE the weakest concordance between the predicted and implanted device for both MATRIX and IFU charts. The percentage of patients in whom the disagreement among the predicted and implanted device represented >1 size was higher when using the IFU chart. In elliptical LAA anatomies, the differences favoring the use of MATRIX compared to the IFU in terms of predicted/implanted agreement were higher. Finally, no significant differences in clinical or imaging endpoints were observed between the two different sizing charts.CONCLUSIONS: Incorporating both the LAA maximum and minimum diameters, as opposed to just maximum diameter, appears to improve sizing accuracy. The proposed MATRIX sizing chart offered a higher level of concordance between predicted and implanted device compared to the current IFU.

KW - Atrial Appendage/diagnostic imaging

KW - Atrial Fibrillation/diagnostic imaging

KW - Cardiac Catheterization/adverse effects

KW - Echocardiography, Transesophageal

KW - Humans

KW - Retrospective Studies

KW - Treatment Outcome

U2 - 10.1002/ccd.30406

DO - 10.1002/ccd.30406

M3 - Journal article

C2 - 36153649

VL - 100

SP - 801

EP - 809

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 5

ER -