{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:08:43Z","timestamp":1791410923235,"version":"4.3.3"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,5]],"date-time":"2018-08-05T00:00:00Z","timestamp":1533427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the effect of left atrial appendage (LAA) occlusion device positioning upon periprocedural and long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The Amulet device is designed to cover the ostium of the LAA. Prolapse of the device into the neck of the LAA is not uncommon resulting in incomplete coverage of the ostium. The clinical consequences of this remain uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcomes of 87 patients with successful LAA closure were analyzed according to Amulet disc position: group A (<jats:italic>n<\/jats:italic>\u2009=\u200945) had complete LAA ostium coverage; group B (<jats:italic>n<\/jats:italic>\u2009=\u200942) had incomplete ostium coverage because of disc prolapse. Periprocedural major adverse events (MAE) (composite of all cause death, tamponade, device\/air embolization, cerebrovascular events, myocardial infarction, and major bleeding not related to vascular access complications) and total device\u2010related periprocedural adverse events (defined as MAE and pericardial effusion) were evaluated. All patients were followed up longitudinally with long\u2010term events defined as a composite of: cardiovascular death, cerebrovascular events, systemic embolization, and major bleeding requiring transfusion or intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up was 234 days (IQR 150\u2013436 days). There was a trend toward more periprocedural MAE in group B (<jats:italic>P<\/jats:italic>\u2009=\u20090.07) with deep implantation of the Amulet device associated with significantly more periprocedural adverse events (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). There were no differences in reposition attempts (<jats:italic>P<\/jats:italic>\u2009=\u20090.9) or long\u2010term events (<jats:italic>P<\/jats:italic>\u2009=\u20090.57).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data suggest that suboptimal device positioning may be associated with worse periprocedural outcomes but no difference in long\u2010term clinical outcomes. The results of this relatively small cohort does not seem to be affected by repositioning attempts during the index procedure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27727","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T08:02:14Z","timestamp":1533628934000},"page":"120-127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Percutaneous left atrial appendage occlusion with the Amulet device: The impact of device disc position upon periprocedural and long\u2010term outcomes"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7810-8092","authenticated-orcid":false,"given":"Kaveh","family":"Oraii Yazdani","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit, San Raffaele Scientific Institute Milan Italy"},{"name":"Tehran Heart Center Tehran 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EMO\u2010GVM Centro Cuore Columbus Milan Italy"},{"name":"Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giannini","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, San Raffaele Scientific Institute Milan Italy"},{"name":"Interventional Cardiology Unit, EMO\u2010GVM Centro Cuore Columbus Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, San Raffaele Scientific Institute Milan Italy"},{"name":"Interventional Cardiology Unit, EMO\u2010GVM Centro Cuore Columbus Milan Italy"},{"name":"Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Regazzoli","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, San Raffaele Scientific Institute Milan 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