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Left Atrial Appendage Occlusion

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www.SCAI.org/Guidelines Key Institutional Requirements (cont'd) Procedural area (cont'd) e interventional suite should be stocked with equipment for safe procedures and for handling complications such as device stabilization, retrieval, and managing pericardial effusions. is equipment includes a variety of endovascular sheaths, diagnostic catheters, transseptal kits, wires, snares, bioptomes, vascular occluders, and pericardiocentesis equipment. Cell–Saver technolog y for rapid processing of drained blood and re-transfusion in case of pericardial effusion and tamponade should be readily available. Imaging Should Include: Fluoroscopy—ideally biplane—for visualization of the relational anatomy in the right anterior oblique and le anterior oblique views Note: These views define the atrioventricular groove and septal planes, although it is recognized that a number of alternate fluoroscopic techniques can be effective and safe. Either transesophageal echocardiography (TEE) or intracardiac echocardiography (ICE) A hemodynamic system to allow for continuous pressure monitoring, which would allow for early recognition of hemodynamic deterioration, including tamponade Echocardiography An echocardiography laboratory with the full array of transthoracic and TEE capabilities should be on site. A TEE-capable machine and probe should be available in the procedure room. Appropriate staff should be present during the procedure, which may include a cardiologist or cardiac anesthesiologist familiar with the procedural steps and subtleties of invasive echocardiography. ree-dimensional echocardiography capability is helpful but not required.

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