{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:22:06Z","timestamp":1783084926447,"version":"3.54.6"},"reference-count":16,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: The left atrial appendage (LAA) is the predominant site of thrombus formation in atrial fibrillation. Current percutaneous LAA occlusion devices require permanent implants. A catheter-based, non-implant mechanical inversion strategy may offer an alternative approach to stroke prevention. Objectives: To assess the feasibility of vacuum-assisted catheter-based inversion of the LAA using transseptal aspiration in a swine model. Methods: A 59-kg domestic swine underwent transseptal access via the right femoral vein under fluoroscopy, transesophageal echocardiography (TEE), and intracardiac echocardiography (ICE). A 22-F aspiration catheter was advanced into the left atrium and positioned at the LAA apex. Negative pressure was generated manually with a 60-mL syringe attached to the aspiration port, and sequential suction\u2013traction maneuvers were performed to induce LAA inversion. Procedural feasibility, hemodynamic stability, imaging changes, and gross pathology were assessed. Results: LAA suction and inversion were feasible. Sequential negative pressure applications resulted in complete inversion, confirmed by multiplane TEE. A mild, non-hemodynamically significant pericardial effusion occurred. Necropsy showed focal apex injury consistent with catheter stiffness and suction forces. Conclusions: Catheter-based vacuum-assisted LAA inversion was technically feasible in this acute swine experiment. However, chronic survival studies are required to evaluate durability of inversion, tissue healing, thrombogenicity, and long-term safety before clinical translation can be considered.<\/jats:p>","DOI":"10.3390\/bioengineering13070777","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"777","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Feasibility of Vacuum-Assisted Catheter-Based Left Atrial Appendage Inversion in a Swine Model"],"prefix":"10.3390","volume":"13","author":[{"given":"Muhammad","family":"Ali","sequence":"first","affiliation":[{"name":"Kardiologische Praxis, Kattowitzer Str. 191 B, 38226 Salzgitter, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Farrell","sequence":"additional","affiliation":[{"name":"Veranex Preclinical Services, 380 Michel St B, Atlanta, GA 30313, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaldoun","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, St\u00e4disches Klinikum Braunschweig, Fichtengrund 1, 38126 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","first-page":"987","article-title":"Anatomy of the left atrial appendage","volume":"91","author":"Ho","year":"2005","journal-title":"Heart"},{"key":"ref_2","first-page":"1464","article-title":"Atrial natriuretic peptide secretion from the left atrial appendage","volume":"22","author":"Yamamoto","year":"1993","journal-title":"J. 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Heart J."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/7\/777\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:56:37Z","timestamp":1783083397000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/7\/777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":16,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["bioengineering13070777"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13070777","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}