Left atrial structure and function after percutaneous left atrial appendage transcatheter occlusion (PLAATO): six-month echocardiographic follow-up.
OBJECTIVE
This study was designed to evaluate the effects of percutaneous left atrial appendage transcatheter occlusion (PLAATO) on the anatomic and hemodynamic properties of the mitral valve (MV) and left upper pulmonary vein (LUPV).


BACKGROUND
PLAATO is a device designed to seal the neck of the left atrial (LA) appendage and reduce embolization in patients with atrial fibrillation intolerant of warfarin. The impact of deployment of this device on adjacent structures has not been reported.


METHODS
Patients with atrial fibrillation participating in the ongoing study for evaluation of PLAATO were enrolled. Transesophageal echocardiographies at baseline, one, and six months were reviewed to measure LA and LUPV dimensions, degree of mitral regurgitation, stability of the device, peak MV E-wave velocity, and peak systolic and diastolic flow velocities in the LUPV. Data were analyzed by a linear mixed model for repeated measures.


RESULTS
Eleven patients (mean age of 72 +/- 7 years) completed six months of follow-up. Left upper pulmonary vein diameter (mean: 1.55, 1.61, 1.54 cm, p = 0.13) and peak systolic (mean: 0.38, 0.34, 0.31 m/s, p = 0.72) and diastolic flow velocities (mean: 0.39, 0.40, 0.42 m/s, p = 0.46) did not differ over the follow-up period. Left atrial size, mitral regurgitation severity, and MV peak E-wave velocities (mean: 0.94, 0.94, 0.82 m/s, p = 0.58) showed no significant change from baseline. The devices remained stable at their sites of deployment with minimal residual flow around them.


CONCLUSIONS
PLAATO achieved an adequate seal of the neck of the left atrial appendage without significant effect on the structure or function of the LA and LUPV.
Hanna
Ibrahim R
IR
Department of Medicine, Emory University, Atlanta, Georgia 30322, USA.
Kolm
Paul
P
Martin
Randolph
R
Reisman
Mark
M
Gray
William
W
Block
Peter C
PC
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D016279:Atrial Function, Left / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013923:Thromboembolism / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*