{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:44:08Z","timestamp":1788237848605,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"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":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to find imaging risk features for device related\u2010pulmonary artery (PA) injury (DR\u2010PAI) in patients after left atrial appendage closure (LAAC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac tamponade resulting from DR\u2010PAI is a rare but life\u2010threatening complication of LAAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In vitro analysis of Amplatzer\u2122 Amulet\u2122 (Abbott, MN) device was done. Measurements of the distance between PA and Amplatzer lobe at its middle part, distal part, and along the stabilizing wires' trajectory (wires\u2010to\u2010PA distance) were taken in 100 consecutive patients on post\u2010LAAC computed tomography (CT) studies. Clinical outcomes were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In vitro analysis indicated that both middle and distal lobe had to be in close PA proximity (&lt;1.5\u2009mm) for the stabilizing wires to cause risk for DR\u2010PAI, configuration called ''cuddling lobe orientation''. On CT measurements middle lobe\u2010PA distance was 4.7\u2009mm (IQR\u00a0=\u00a02.7\u20139.5), with close proximity in 4 (4%) patients, and distal lobe\u2010PA distance was 3.2\u2009mm (IQR\u00a0=\u00a01.8\u20137.2\u2009mm), with close proximity in 17 (17%) patients. Stabilizing wires were pointing toward PA in 47 patients (47%) with median wire\u2010to\u2010PA distance 5.7\u2009mm (IQR\u00a0=\u00a03.6\u20138.5\u2009mm). ''Cuddling'' was found in 2 (2%) patients and resulted in shorter wires\u2010to\u2010PA distance vs no ''cuddling'' group (2.3 vs 5.8\u2009mm <jats:italic>p<\/jats:italic>\u00a0&lt;.01). At 2.9\u2009\u00b1\u20091.0\u00a0yrs of follow\u2010up, the two patients with ''cuddling lobe orientation'' on post\u2010LAAC CT scan developed late cardiac tamponades (<jats:italic>p<\/jats:italic>\u00a0&lt;.001). One of those required surgery, which confirmed DR\u2010PAI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>''Cuddling lobe orientation'' of Amulet device with the PA was associated with short wires\u2010to\u2010PA distance and late pericardial effusions, including DR\u2010PAI. Hence, such device\u2010to\u2010PA configuration should be avoided.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29393","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T15:36:55Z","timestamp":1605973015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Imaging risk features for device related pulmonary artery injury after left atrial appendage closure with <scp>Amplatzer\u2122 Amulet\u2122<\/scp> device"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7519-0003","authenticated-orcid":false,"given":"Rados\u0142aw","family":"Praco\u0144","sequence":"first","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9674-0278","authenticated-orcid":false,"given":"Ole","family":"De Backer","sequence":"additional","affiliation":[{"name":"Rigshospitalet Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Konka","sequence":"additional","affiliation":[{"name":"Congenital Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cezary","family":"K\u0119pka","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"Kruk","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Trochimiuk","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"D\u0119bski","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zofia","family":"Dzieli\u0144ska","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Rigshospitalet Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Demkow","sequence":"additional","affiliation":[{"name":"Coronary and Structural Heart Diseases Department National Institute of Cardiology  Warsaw 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