Impact of intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion procedures: A meta-analysis / Diaz, Juan Carlos  

Público ISBD [Publicación periódica]  Título : Impact of intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion procedures: A meta-analysis Tipo de documento : documento electrónico Autores : Diaz, Juan Carlos, Autor ; Oriana Cristina Bastidas Ayala, Autor ; Mauricio Duque, Autor ; Marín, Jorge E, Autor ; Aristizábal, Julian, Autor ; César Daniel Niño Pulido, Autor ; Hoyos, Carolina, Autor ; Matos, Carlos D, Autor ; Gabr, Mohamed, Autor ; Steiger, Nathaniel A, Autor ; Kapur, Sunil, Autor ; Sahuer, William H, Autor ; Romero, Jorge E, Autor Fecha de publicación : 2024 ISBN/ISSN/DL : 98700011902 Idioma : Inglés (eng) Palabras clave : Intracardiac echocardiography; left atrial appendage occlusion; meta-analysis; transesophageal echocardiography. Clasificación: AC-2024-007 Resumen : Background: Intracardiac echocardiography (ICE) is increasingly used during left atrial appendage occlusion (LAAO) as an alternative to transesophageal echocardiography (TEE). The objective of this study is to evaluate the impact of ICE versus TEE guidance during LAAO on procedural characteristics and acute outcomes, as well the presence of peri-device leaks and residual septal defects during follow-up. Methods: All studies comparing ICE-guided versus TEE-guided LAAO were identified. The primary outcomes were procedural efficacy and occurrence of procedure-related complications. Secondary outcomes included lab efficiency (defined as a reduction in in-room time), procedural time, fluoroscopy time, and presence of peri-device leaks and residual interatrial septal defects (IASD) during follow-up. Results: Twelve studies (n = 5637) were included. There were no differences in procedural success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p = .27; I2 = 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p = .25; I2 = 0%) between the ICE-guided and TEE-guided groups. ICE guidance reduced in in-room time (mean-weighted 28.6-min reduction in in-room time) without differences in procedural time or fluoroscopy time. There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27, p = 0.64); however, an increased prevalence of residual IASD was observed with ICE-guided versus TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI 1.05-4.75, p = 0.04). Conclusion: ICE guidance is associated with similar procedural efficacy and safety, but could result in improved lab efficiency (as established by a significant reduction in in-room time). No differences in the rate of periprocedural leaks were found. A higher prevalence of residual interatrial septal defects was observed with ICE guidance. DOI (Digital Object Identifier) : 10.1111/jce.16118 Derechos de uso : Permiso de republicación otorgado al HPTU En línea : https://pubmed.ncbi.nlm.nih.gov/37927196/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6168 [Publicación periódica] Impact of intracardiac echocardiography versus transesophageal echocardiography guidance on left atrial appendage occlusion procedures: A meta-analysis [documento electrónico] / Diaz, Juan Carlos, Autor ; Oriana Cristina Bastidas Ayala, Autor ; Mauricio Duque, Autor ; Marín, Jorge E, Autor ; Aristizábal, Julian, Autor ; César Daniel Niño Pulido, Autor ; Hoyos, Carolina, Autor ; Matos, Carlos D, Autor ; Gabr, Mohamed, Autor ; Steiger, Nathaniel A, Autor ; Kapur, Sunil, Autor ; Sahuer, William H, Autor ; Romero, Jorge E, Autor . - 2024. ISSN : 98700011902 Idioma : Inglés (eng) Palabras clave : Intracardiac echocardiography; left atrial appendage occlusion; meta-analysis; transesophageal echocardiography. Clasificación: AC-2024-007 Resumen : Background: Intracardiac echocardiography (ICE) is increasingly used during left atrial appendage occlusion (LAAO) as an alternative to transesophageal echocardiography (TEE). The objective of this study is to evaluate the impact of ICE versus TEE guidance during LAAO on procedural characteristics and acute outcomes, as well the presence of peri-device leaks and residual septal defects during follow-up. Methods: All studies comparing ICE-guided versus TEE-guided LAAO were identified. The primary outcomes were procedural efficacy and occurrence of procedure-related complications. Secondary outcomes included lab efficiency (defined as a reduction in in-room time), procedural time, fluoroscopy time, and presence of peri-device leaks and residual interatrial septal defects (IASD) during follow-up. Results: Twelve studies (n = 5637) were included. There were no differences in procedural success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p = .27; I2 = 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p = .25; I2 = 0%) between the ICE-guided and TEE-guided groups. ICE guidance reduced in in-room time (mean-weighted 28.6-min reduction in in-room time) without differences in procedural time or fluoroscopy time. There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27, p = 0.64); however, an increased prevalence of residual IASD was observed with ICE-guided versus TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI 1.05-4.75, p = 0.04). Conclusion: ICE guidance is associated with similar procedural efficacy and safety, but could result in improved lab efficiency (as established by a significant reduction in in-room time). No differences in the rate of periprocedural leaks were found. A higher prevalence of residual interatrial septal defects was observed with ICE guidance. DOI (Digital Object Identifier) : 10.1111/jce.16118 Derechos de uso : Permiso de republicación otorgado al HPTU En línea : https://pubmed.ncbi.nlm.nih.gov/37927196/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6168

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