A novel device for left atrial appendage exclusion.
OBJECTIVE
The left atrial appendage is a frequent source of thromboemboli in patients with atrial fibrillation. Exclusion or excision of the left atrial appendage may reduce the risk of stroke in patients with atrial fibrillation. We evaluated the ability of a novel device to exclude the left atrial appendage during early and intermediate follow-up periods in a canine model.


METHODS
Eight mongrel dogs (mean weight 29.1 +/- 4.0 kg) were used in this study. The occlusion device, constructed from 2 stainless steel strips covered with a knit braided polyester fabric, was implanted at the base of the left atrial appendage through a left thoracotomy on a beating heart. Dogs were evaluated at 7 days (n = 2), 30 days (n = 2), and 90 days (n = 4) by epicardial echocardiography, left atrial angiography, histologic inspection, and gross pathology.


RESULTS
Device implantation was performed without complications in all animals. Complete exclusion of the left atrial appendage from the circulation was confirmed acutely and chronically by echocardiographic and angiographic evaluations. There was no device migration or damage to adjacent structures.


CONCLUSIONS
This novel device enables rapid, reliable, and safe exclusion of the left atrial appendage. The device provides a new therapeutic option for reducing the risk of stroke in patients with atrial fibrillation.
Kamohara
Keiji
K
Biomedical Engineering, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Fukamachi
Kiyotaka
K
Ootaki
Yoshio
Y
Akiyama
Masatoshi
M
Zahr
Firas
F
Kopcak
Michael W
MW
Dessoffy
Raymond
R
Popović
Zoran B
ZB
Daimon
Masao
M
Cosgrove
Delos M
DM
Gillinov
A Marc
AM
D000818:Animals; D020517:Atrial Appendage; D004285:Dogs; D004867:Equipment Design; D019736:Prostheses and Implants; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control