Left atrial appendage occlusion device causing coronary obstruction: A word of caution.
NSTEMI
cardiac complications
coronary artery stenosis
left atrial appendage occlusion
Journal
Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
06
10
2020
revised:
12
11
2020
accepted:
13
11
2020
pubmed:
18
12
2020
medline:
15
5
2021
entrez:
17
12
2020
Statut:
ppublish
Résumé
Closure of the left atrial appendage is a common procedure for patients with atrial fibrillation undergoing cardiac surgery. The technique of left atrial appendage occlusion (LAAO) by an extracardiac clip (AtriClip) is established as a reliable method. Acute coronary obstruction of the circumflex artery has already been described after minimally invasive LAAO. Here, we report a case of delayed circumflex artery obstruction after open-heart surgery. A patient who had mitral and tricuspid valve surgery in combination with AtriClip implantation suffered from myocardial infarction 24 h after clip implantation. Cardiac catheterization showed that the circumflex artery was obstructed on the level of the AtriClip device. The stenosis was treated by percutaneous coronary intervention with stent implantation. In conclusion, the surgeon should consider placing the AtriClip device slightly far away from the base of the left atrial appendage to avoid coronary obstruction.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
723-725Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.
Références
Martin Gutierrez E, Castano M, Gualis J, et al. Beneficial effect of left atrial appendage closure during cardiac surgery: a meta-analysis of 280 585 patients. Eur J Cardiothorac Surg. 2020;57(2):252-262.
Toale C, Fitzmaurice GJ, Eaton D, Lyne J, Redmond KC. Outcomes of left atrial appendage occlusion using the AtriClip device: a systematic review. Interact Cardiovasc Thorac Surg. 2019;29(5):655-662.
Chaldoupi SM, Heuts S, Vainer J, Maesen B. Surgical options to tackle coronary artery kinking in thoracoscopic left atrial appendage clipping. Ann Thorac Surg. 2020;110(2):e119-e121.
Lindner S, Behnes M, Wenke A, et al. Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography. Clin Cardiol. 2019;42(2):264-269.
Katona A, Temesvari A, Szatmari A, Nemes A, Forster T, Fontos G. Left circumflex coronary artery occlusion due to a left atrial appendage closure device. Postepy Kardiol Interwencyjnej. 2015;11(1):69-70.