eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2024
vol. 21
 
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abstract:
Original paper

Combining echocardiography and fluoroscopy imaging in real time for left atrial appendage occlusion – single center experience from Poland

Marian Burysz
1
,
Jakub Batko
2
,
Michalina Helena Malec-Litwinowicz
3
,
Mariusz Kowalewski
4
,
Radosław Adam Litwinowicz
1
,
Aleksandra Burysz
5
,
Łukasz Graczykowski
6
,
Wojciech Olejek
2

  1. Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland
  2. CAROL – Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  3. Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
  4. Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
  5. Department of Thoracic Surgery and Tumors, Oncology Centre, Prof. Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
  6. Department of Cardiology, Specialist Hospital, Wloclawek, Poland
Kardiochirurgia i Torakochirurgia Polska 2024; 21 (1): 30-34
DOI: https://doi.org/10.5114/kitp.2024.138575
Online publish date: 2024/03/30
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Introduction
Atrial fibrillation (AF) presents a growing health concern, often requiring stroke prevention measures, primarily through oral anticoagulation (OAC). Surgical interventions such as left atrial appendage occlusion (LAAO) offer alternatives when OAC is contraindicated. In recent years, percutaneous procedures have gained traction as minimally invasive options, demanding precise anatomical insights. Fusion imaging (FI), which combines transesophageal echocardiography (TEE) and fluoroscopy, has emerged as a potential game-changer in transcatheter interventions.

Aim
This study introduces FI to LAAO procedures in Poland, assessing its role in guiding interventions, highlighting advantages, and exploring its potential to reshape cardiovascular interventions.

Material and methods
We conducted a retrospective study involving LAAO procedures from March 2015 to December 2018, all utilizing FI. Patient indications, procedural specifics, and safety metrics were collected and analyzed. Follow-ups were conducted at 3 and 6 months.

Results
A cohort of 83 patients (mean age: 72.1 ±8.4 years) underwent successful LAAO procedures. FI provided precise device placement and anatomical assessment. Mean procedure time was 54.9 ±34.3 min, contrast medium usage averaged 33.7 ±22.7 ml, and creatinine levels remained stable. Patients were discharged in about 4.2 ±3.4 days. Adverse effects were rare, including minimal bleeding and cardiac tamponade. Follow-ups demonstrated favorable outcomes with low adverse event rates.

Conclusions
This study marks the inaugural application of FI in Polish LAAO procedures. FI, offering enhanced visualization and reduced procedure times, holds promise in improving patient safety and treatment efficacy. We recommend its consideration as a standard visualization technique for LAAO procedures.

keywords:

atrial fibrillation, left atrial appendage occlusion, fusion imaging, percutaneous intervention, cardiovascular procedures
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