LARIAT device
A review of
the LARIAT device: insights from the cumulative clinical experience. Advancement of the pericardial access needle with small injections of dye allows recognition of pericardial access site with tenting of the pericardium
A review of
the LARIAT device: insights from the cumulative clinical experience. Pericardial access planning in the AP and LL projections. a In the AP projection, Kelley clamps are placed below the sub-xiphoid process and at the likely position of the LAA (Δ) based on the position of the PA (*). The ideal trajectory of trans-septal sheath placement is lateral to the LAA in the region between the dashed red arrows. b In the LL view, the pericardial silhouette (orange dashed line) can be approximated by performing a right ventriculogram outlining the RV endocardium. The anterior pericardium is entered following the tract of the dotted yellow arrow. The xiphoid process tip is noted at the short red arrow
A review of
the LARIAT device: insights from the cumulative clinical experience. a The dashed line indicates the desired ligation site, just inferior to the Coumadin ridge (arrow). b The proximal end of the balloon is positioned at the LAA orifice under TEE guidance. The radio-opaque marker at the proximal end of the balloon (arrow) guides advancement of the LARIAT system over the LAA os under fluoroscopy; PV pulmonary vein
A review of
the LARIAT device: insights from the cumulative clinical experience. a LA angiography post LARIAT LAAO without flow into the snared LAA b TEE demonstrating residual 1 mm jet of flow into the ligated LAA (yellow arrow)
A review of
the LARIAT device: insights from the cumulative clinical experience. Complications noted during follow-up TEE after LARIAT LAAO. a Thrombus at the site of LAA ligation (*). b Residual LAA stump with pectinate muscle in LA (arrow)
