dc.creator | Ruiz-Salmerón, Rafael José | es |
dc.creator | Robles-Pérez, Carlos | es |
dc.creator | Ronquillo-Japón, María | es |
dc.creator | García-Borbolla, Rafael | es |
dc.creator | Iglesias-Blanco, Manuel | es |
dc.creator | Méndez-Santos, Irene | es |
dc.creator | Polo Padillo, Juan | es |
dc.date.accessioned | 2022-09-28T13:11:31Z | |
dc.date.available | 2022-09-28T13:11:31Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Ruiz-Salmerón, R.J., Robles-Pérez, C., Ronquillo-Japón, M., García-Borbolla, R., Iglesias-Blanco, M., Méndez-Santos, I. y Polo Padillo, J. (2021). Comparison of Different Procedural Approaches for Left Atrial Appendage Closure: Searching for Simplicity. Journal of Interventional Cardiology | |
dc.identifier.issn | 0896-4327 (impreso) | es |
dc.identifier.issn | 1540-8183 (electrónico) | es |
dc.identifier.uri | https://hdl.handle.net/11441/137428 | |
dc.description.abstract | To assess procedural and long-term efficacy and safety of two alternative methods for appendage closure, conscious sedation
with standard transoesophageal echo and procedure guided by rotational angiography. Background. Demand for appendage
closure is increasing, and a reasonable time-response should be given to nonvalvular atrial fibrillation patients not suitable to
receive anticoagulation. General anesthesia and the need for an anesthesiologist are limiting factors to improve procedure
availability; it is time to introduce simpler approaches. Methods. Single center experience in appendage closure during 9 years,
using three different procedural approaches: general anesthesia with echo guidance, conscious sedation with echo guidance, and
rotational angiography guidance. Conscious sedation and rotational angiography-guided procedures were performed in the
absence of an anesthesiologist. Procedural characteristics and follow-up events were recorded. Results. 260 consecutive appendage
closure procedures were reviewed: 155 were performed under general anesthesia (59.6%), 71 were performed with conscious
sedation (27.3%), and 34 were rotational angiography guided (13.1%). Device success rate for procedures guided by rotational
angiography was significantly lower than that for general anesthesia and conscious sedation (91.2% versus 100% versus 98.6%,
p � 0.001) because there was a greater need to recapture and change device size. However, final procedural success was high and
without difference between approaches (98.8% versus 97.2% versus 100%, for general anesthesia, conscious sedation, and rotational
angiography, respectively); with a median follow-up of 17 months (CI 95% 13–23 month) (637.9 patients-year), there was
no difference among approaches for thromboembolic (1.3 versus 1.8 versus 1.8) and major bleeding events (3.2 versus 2.8 versus
1.8), respectively. Conclusions. Appendage closure performed, either with conscious sedation with echo guidance or rotational
angiography guided, is feasible, with no difference in procedural success and follow-up events compared with general anesthesia
and without the limitation of the need for an anesthesiologist on-site. | es |
dc.format | application/pdf | es |
dc.format.extent | 7 p. | es |
dc.language.iso | eng | es |
dc.publisher | Wiley | es |
dc.relation.ispartof | Journal of Interventional Cardiology | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.title | Comparison of Different Procedural Approaches for Left Atrial Appendage Closure: Searching for Simplicity | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública | es |
dc.relation.publisherversion | https://www.hindawi.com/journals/jitc/2021/8841342/ | es |
dc.identifier.doi | 10.1155/2021/8841342 | es |
dc.journaltitle | Journal of Interventional Cardiology | es |