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Medical Ultrasonography Sep 2023
Topics: Humans; Ebstein Anomaly; Atrial Fibrillation; Heart Atria; Thrombosis
PubMed: 37778027
DOI: 10.11152/mu-4236 -
Current Cardiology Reviews 2021Right atrial thrombus can originate from distal venous sources or can be iatrogenic, secondary to the placement of central venous catheters, atrial devices, or... (Review)
Review
Right atrial thrombus can originate from distal venous sources or can be iatrogenic, secondary to the placement of central venous catheters, atrial devices, or surgeries. One of the most common complications of Central Venous Catheters (CVCs) is thromboembolism, which can be either fixed to the right atrium or can be free-floating. Device-related Right Atrial Thrombosis (RAT) can result in catheter occlusion, vascular occlusion, infection, and pulmonary embolism. The true incidence of these complications is unknown because the diagnosis may not be considered in asymptomatic patients, and it might be missed by Transthoracic Echocardiography (TTE). In this literature review, we discuss iatrogenic etiologies of RAT that is complicated by pulmonary embolism. We highlight the importance of maintaining a high index of suspicion of iatrogenic RAT, possible complications, and its management.
Topics: Heart Atria; Heart Diseases; Humans; Iatrogenic Disease; Pulmonary Embolism; Thromboembolism; Thrombosis
PubMed: 33238847
DOI: 10.2174/1573403X16999201124201632 -
EuroIntervention : Journal of EuroPCR... May 2016Left atrial appendage closure (LAAC), a device-based therapy for stroke prevention in patients with atrial fibrillation, is considered an alternative to oral... (Review)
Review
Left atrial appendage closure (LAAC), a device-based therapy for stroke prevention in patients with atrial fibrillation, is considered an alternative to oral anticoagulation therapy, particularly for patients at high risk of bleeding. Proof of concept has been demonstrated by the PROTECT AF and PREVAIL trials which evaluated the WATCHMAN device (Boston Scientific, Marlborough, MA, USA) versus warfarin, showing favourable outcome for the device group. The most commonly used devices for LAAC are the WATCHMAN and its successor, the WATCHMAN FLX (Boston Scientific) and the AMPLATZER Cardiac Plug and more recently the AMPLATZER Amulet device (both St. Jude Medical, St. Paul, MN, USA). The procedure is typically performed via a transseptal puncture under fluoroscopic and echocardiographic guidance. Technically, it is considered quite demanding due to the anatomic variability and fragility of the appendage. Careful material manipulation, adequate operator training, and good cardiac imaging and device sizing allow a safe, uneventful procedure. Post-procedure antithrombotic drug selection is based on the patient's history, indication and quality of LAAC.
Topics: Atrial Fibrillation; Endovascular Procedures; Fibrinolytic Agents; Heart Atria; Humans; Postoperative Complications; Postoperative Period; Stroke; Thrombosis
PubMed: 27174112
DOI: 10.4244/EIJV12SXA10 -
Romanian Journal of Morphology and... 2013Histological abnormalities are common findings in the left atria (LA) of atrial fibrillation (AF) patients. We aimed to assess LA histological abnormalities in our model...
INTRODUCTION
Histological abnormalities are common findings in the left atria (LA) of atrial fibrillation (AF) patients. We aimed to assess LA histological abnormalities in our model of spontaneous atrial tachyarrhythmias in rats.
MATERIALS AND METHODS
LA sampling was performed in 12 spontaneously hypertensive rats (SHRs) and eight age-matched Wistar-Kyoto (WKY) rats. Tissue sections were stained with Masson's trichrome and Hematoxylin-Eosin-Safran and examined with a light microscope. A 0 to 3 scoring system was used to quantify the severity of LA structural abnormalities. LA von Willebrand factor (vWF) content was also assessed using immunohistochemical staining.
RESULTS
In six of the eight SHRs, LA fibrosis, inflammatory infiltrates, and myocyte necrosis of varying grades of severity were observed. The most frequent feature was endocardial fibrosis, which was observed in six SHRs and in none of the WKY rats. Intra-atrial thrombosis was found in three SHRs and in none of the WKY rats. The intensity of vWF-related fluorescence was higher in the atrial endocardium of SHRs compared to age-matched WKY rats.
CONCLUSIONS
Our findings reinforce the role of LA structural abnormalities in atrial arrhythmogenicity. However, two SHRs did not present LA histological abnormalities despite the presence of arrhythmias. This finding suggests that the LA remodeling-atrial tachyarrhythmia relationship could be highly nonlinear and that atrial fibrosis is more likely to be a facilitator of atrial arrhythmogenicity, rather than a prerequisite. We also provide evidence that intra-atrial thrombosis accompanies LA structural remodeling in arrhythmic rats. Increased endocardial platelet adhesion molecule vWF could contribute to this increased thrombogenicity.
Topics: Animals; Atrial Remodeling; Endocardium; Fibrosis; Heart Atria; Heart Diseases; Male; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Tachycardia; Thrombosis; von Willebrand Factor
PubMed: 23771089
DOI: No ID Found -
Texas Heart Institute Journal Apr 2020Assessing thromboembolic risk is crucial for proper management of patients with atrial fibrillation. Left atrial volume is a promising predictor of cardiac thrombosis....
Assessing thromboembolic risk is crucial for proper management of patients with atrial fibrillation. Left atrial volume is a promising predictor of cardiac thrombosis. To determine whether left atrial volume can predict left atrial appendage thrombus in patients with atrial fibrillation, we conducted a prospective study of 73 patients. Left atrial and ventricular volumes were evaluated by cardiac computed tomography with retrospective electrocardiographic gating and then indexed to body surface area. Left atrial appendage thrombus was confirmed or excluded by cardiac computed tomography with delayed enhancement. Seven patients (9.6%) had left atrial appendage thrombus; 66 (90.4%) did not. Those with thrombus had a significantly higher mean left atrial end-systolic volume index (139 ± 55 vs 101 ± 35 mL/m2; P =0.0097) and mean left atrial end-diastolic volume index (122 ± 45 vs 84 ± 34 mL/m2; P =0.0077). On multivariate logistic regression analysis, left atrial end-systolic volume index (per 10 mL/m2 increase) was significantly associated with left atrial appendage thrombus (odds ratio [OR]=1.24; 95% CI, 1.03-1.50; P =0.02); so too was the left atrial end-diastolic volume index (per 10 mL/m2 increase) (OR=1.29; 95% CI, 1.05-1.60; P =0.02). These findings suggest that increased left atrial volume increases the risk of left atrial appendage thrombus. Therefore, patients with atrial fibrillation and an enlarged left atrium should be considered for cardiac computed tomography with delayed enhancement to confirm whether thrombus is present.
Topics: Aged; Atrial Appendage; Atrial Fibrillation; Cardiac Volume; Female; Heart Atria; Heart Diseases; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Thrombosis; Tomography, X-Ray Computed
PubMed: 32603460
DOI: 10.14503/THIJ-17-6290 -
Mathematical Biosciences and... Feb 2020The remodeling of the left atrial morphology and function caused by atrial fibrillation (AF) can exacerbate thrombosis in the left atrium (LA) even spike up the risk of...
The remodeling of the left atrial morphology and function caused by atrial fibrillation (AF) can exacerbate thrombosis in the left atrium (LA) even spike up the risk of stroke within AF patients. This study explored the effect of the AF on hemodynamic and thrombosis in LA. We reconstructed the patient-specific anatomical shape of the LA and considered the non-Newtonian property of the blood. The thrombus model was applied in the LA models to simulate thrombosis. Our results indicate that AF can aggravate thrombosis which mainly occurs in the left atrial appendage (LAA). Thrombosis first forms on the LAA wall then expands toward the internal LAA. The proposed computational model also shows the potential application of numerical analyses to help assess the risk of thrombosis in AF patients.
Topics: Atrial Appendage; Atrial Fibrillation; Heart Atria; Hemodynamics; Humans; Thrombosis
PubMed: 32233539
DOI: 10.3934/mbe.2020125 -
European Journal of Vascular and... Jan 2022
Topics: Accidents, Occupational; Aged; Echocardiography, Transesophageal; Heart Atria; Heart Diseases; Humans; Leg Injuries; Male; Thrombosis
PubMed: 34635398
DOI: 10.1016/j.ejvs.2021.09.003 -
JACC. Cardiovascular Interventions Nov 2021
Topics: Anticoagulants; Atrial Appendage; Atrial Fibrillation; Humans; Thrombosis; Treatment Outcome
PubMed: 34656491
DOI: 10.1016/j.jcin.2021.08.004 -
JACC. Clinical Electrophysiology Jan 2023
Topics: Humans; Atrial Appendage; Thrombosis; Atrial Fibrillation
PubMed: 36697188
DOI: 10.1016/j.jacep.2022.11.029 -
Kardiologia Polska 2018
Review
Topics: Atrial Fibrillation; Coronary Thrombosis; Female; Heart Atria; Heart Diseases; Humans; Male; Stroke
PubMed: 29131288
DOI: 10.5603/KP.a2017.0212