{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:08:41Z","timestamp":1791410921312,"version":"4.3.3"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T00:00:00Z","timestamp":1469664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcomes of 169 consecutive patients (age 73.1\u2009\u00b1\u200910.4 years; 76% male) with successful LAA closure were analyzed according to the position of the ACP disc: group A had complete coverage of the LAA ostium; in group B the disc prolapsed partially or completely into the LAA\u2010neck. Transesophageal echocardiography was performed 1\u20106 months after ACP implantation. The safety endpoint was the composite of clinically significant pericardial effusion, device embolization, procedure\u2010related stroke\/transient ischemic attack (TIA), major bleeding, or device thrombus. The efficacy endpoint was the composite of death, neurological events (ischemic and hemorrhagic stroke, TIA), or systemic embolism during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Group A comprised 76 patients (age 73.0\u2009\u00b1\u20099.9 years; 74% male) and group B 93 patients (age 73.3\u2009\u00b1\u200910.9 years; 79% male). Mean CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010Vasc score and HASBLED score were 4.2\u2009\u00b1\u20091.7 (group A 4.3\u2009\u00b1\u20091.6; group B 4.2\u2009\u00b1\u20091.8) and 2.9\u2009\u00b1\u20091.1 (group A 2.9\u2009\u00b1\u20091.0; group B 3.0\u2009\u00b1\u20091.2), respectively. Mean follow\u2010up of the study population was 13.0\u2009\u00b1\u200910.4 months. Overall, the composite safety and efficacy endpoints occurred in 20 (12%) and 6 patients (4%), respectively. There was no significant difference between groups A and B in the occurrence of the safety endpoint (13% vs. 11%, <jats:italic>P<\/jats:italic>\u2009=\u20090.64), or the efficacy endpoint (4% vs. 3%, <jats:italic>P<\/jats:italic>\u2009=\u20091.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No evidence for a difference in the occurrence of the safety and efficacy endpoint was found between patients with complete vs. incomplete ACP disc coverage of the LAA ostium. The risk of repositioning attempts in case of incomplete coverage does not seem to be warranted. Current findings need further confirmation in a larger scale clinical trial. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26646","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T08:29:13Z","timestamp":1469694553000},"page":"656-664","source":"Crossref","is-referenced-by-count":17,"title":["Percutaneous left atrial appendage occlusion: Effect of device positioning on outcome"],"prefix":"10.1002","volume":"88","author":[{"given":"Mathias","family":"Wolfrum","sequence":"first","affiliation":[{"name":"University Heart Center University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Attinger\u2010Toller","sequence":"additional","affiliation":[{"name":"University Heart Center University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samera","family":"Shakir","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Gloekler","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhardt","family":"Seifert","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology Biostatistics and Prevention Institute, University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aris","family":"Moschovitis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Khattab","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maisano","sequence":"additional","affiliation":[{"name":"University Heart Center University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Nietlispach","sequence":"additional","affiliation":[{"name":"University Heart Center University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00887-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0021-8782.2004.00330.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10660"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.03.042"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61343-X"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24872"},{"key":"e_1_2_6_8_1","article-title":"Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug","volume":"10","author":"Tzikas A","year":"2015","journal-title":"EuroIntervention"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15192"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.089"},{"key":"e_1_2_6_11_1","first-page":"296","article-title":"Percutaneous left atrial appendage occlusion for stroke prophylaxis in nonvalvular atrial fibrillation","volume":"7","author":"Bajaj NS","year":"2014","journal-title":"A systematic review and analysis of observational studies. 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