Endovascular occlusion of the left atrialaud in patients with atrial fibrillations. Experience of city hospital
V. V. Guryev,
S. V. Vlasenko,
S. G. Shcherbak,
D. N. Lazakovich,
A. A. Khilchuk,
M. V. Agarkov,
V. V. Semenyuta,
D. A. Vorobyevsky,
D. V. Gladyshev,
A. M. Osadchiy https://doi.org/10.18705/2311-4495-2021-6-24-32
Abstract
Background. Endovascular occlusion of the left atrial appendage (LAA) using the Watchman device may be considered an adequate alternative to oral anticoagulant (OAC) administration in high-risk patients.
Objective. To describe our experience with Watchman endovascular occlusion of the left atrial appendage in a city hospital setting in terms of feasibility and safety, as well as assess the short-term efficacy of this procedure.
Design and methods. The study included patients who underwent implantation of the Watchman occlusion device from January 2016 to November 2020. The effectiveness of the procedure was defined as the ability to implant the Watchman without maintaining residual current, safety was defined as the occurrence of nosocomial and 45-day events including stroke, pericardial effusion, major bleeding, and device migration.
Results. The study included 22 patients: 10 men and 12 women, who underwent implantation of the Watchman occluding device in the LAA. The indication for implantation was a history of gastrointestinal bleeding in 15 patients, cerebral hemorrhage in 3 patients and low compliance to therapy in 4 patients. The success rate of the procedure was 95.7 %. According to control transesophageal echocardiography, after 45 days LAA was excluded from the bloodstream in 21 of 22 patients.
Conclusion. Despite the higher complication rate of occlusion of the LAA compared to drug treatment, the overall mortality from any cause in patients with the implanted Watchman was lower.
About the Authors
V. V. Guryev
City Hospital № 40
Russian Federation
Competing Interests:
Russian Federation
Valentin V. Guryev, Interventional cardiologist
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
S. V. Vlasenko
City Hospital № 40; Saint-Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Sergey V. Vlasenko, Ph.D., Interventional cardiologist, Chief of Department; Associate Professor of the Department of Postgraduate Medical Education, Faculty of Medicine
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
S. G. Shcherbak
City Hospital № 40; Saint-Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Sergei G. Shcherbak, Doctor of Medical Sciences, Professor, Head of the Department of Postgraduate Medical Education; Chief physician
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
D. N. Lazakovich
City Hospital № 40
Russian Federation
Competing Interests:
Russian Federation
Dmitriy N. Lazakovich, Interventional cardiologist
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
A. A. Khilchuk
City Hospital № 40; Saint-Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Anton A. Khilchuk, Interventional cardiologist, assistant at the Department of Postgraduate Medical Education, Faculty of Medicine
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
M. V. Agarkov
Gusev Central District Hospital
Russian Federation
Competing Interests:
Russian Federation
Maxim V. Agarkov, Interventional cardiologist, Chief Freelance Specialist of the Kaliningrad Region, Head of the Interventional cardiology Department of the RSC
Gusev
Competing Interests:
The authors declare no conflict of interest
V. V. Semenyuta
North-Western State Medical University named after I. I. Mechnikov
Russian Federation
Competing Interests:
Russian Federation
Vyacheslav V. Semenyuta, Cardiovascular surgeon
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
D. A. Vorobyevsky
City Hospital № 40
Russian Federation
Competing Interests:
Russian Federation
Dmitry A. Vorobyevsky, Interventional cardiologist
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
D. V. Gladyshev
City Hospital № 40; Saint-Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Dmitry V. Gladyshev, Doctor of Medical Sciences, Deputy Chief physician for surgery, chief oncologist of the Health Committee
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
A. M. Osadchiy
City Hospital № 40
Russian Federation
Competing Interests:
Russian Federation
Andrey M. Osadchiy, Ph.D., arrhythmologist
Borisova str., 9, Saint Petersburg, 197706
Competing Interests:
The authors declare no conflict of interest
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Review
For citations:
Guryev V.V., Vlasenko S.V., Shcherbak S.G., Lazakovich D.N., Khilchuk A.A., Agarkov M.V., Semenyuta V.V., Vorobyevsky D.A., Gladyshev D.V., Osadchiy A.M. Endovascular occlusion of the left atrialaud in patients with atrial fibrillations. Experience of city hospital. Translational Medicine. 2021;8(6):24-32. (In Russ.) https://doi.org/10.18705/2311-4495-2021-6-24-32
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