Andrea J Ibarra

All Publications

• Assessing Retinal Thickness and Associations with Cognitive Function in Women with History of Preeclampsia. Eye and brain Ibarra, A. J., Phan, B. N., Silverstein, S. M., Chhablani, J., Snyder, V., Rossi, E. A., Butters, M. A., Catov, J. M. 2026; 18: 1-11

  Abstract

  Women with preeclampsia are at risk of developing cognitive changes and dementia later in life. The retina - an extension of the brain - may provide insight about structural changes associated with preeclampsia and serve as a biomarker of long-term neural and vascular consequences. Our goal was to compare retinal thickness measurements between women with and without history of preeclampsia, and to determine associations with cognitive performance.This prospective cohort study recruited preeclampsia (N=17) and normotensive (N=18) women 10-15 years after delivery. We assessed retinal thickness using spectral-domain optical coherence tomography (SD-OCT). Principal component analysis was used to detect retinal regional patterns. Cognitive performance was evaluated to assess memory (Wechsler Memory immediate and delayed), working memory-Letter-Number Sequencing, information processing speed (Digit Symbol, Stroop Word and Color) and executive (WAIS similarities, matrix reasoning, and Stroop interference) domains. Regression models estimated associations between retina measurements, preeclampsia history and cognitive performance.Using the standard early treatment diabetic retinopathy study grid, compared to normotensive, preeclampsia women had thinner outer retina subfields. Similarly, two out of three principal components suggested different patterns of retinal changes at the outer vs central region. The thinner inner nasal and superior quadrants were associated with lower scores on the executive function domain - Stroop Color test (β=12.2, p=0.032; β=12.9, p=0.037, respectively). In the memory domain, Letter-Number sequencing test, preE history significantly altered the relationship with the maximum fovea central subfield (β=-17.3, p=0.013).Our study provides a novel, integrated assessment of preeclampsia by simultaneously evaluating retina and cognitive markers. Retinal imaging 10-15 years after delivery in women with a history of preeclampsia showed a decreased thickness in the outer region of the retina. Selective vulnerability of peripheral retinal regions to persistent microvascular changes after preeclampsia may reflect broader central nervous system changes associated with impairments in information processing speed, executive functioning and working memory.

  View details for DOI 10.2147/EB.S542082

  View details for PubMedID 41551403

  View details for PubMedCentralID PMC12810194

• The Association of Food Security With Hypertensive Disorders of Pregnancy: A National Health Interview Survey Analysis JOURNAL OF CLINICAL HYPERTENSION Burton, B. N., Sykes, A., Canales, C., Ibarra, A. J., Chang, E., Dahan, J., Milam, A. J., Yu, T., Cha, C. 2025; 27 (1): e14952

  Abstract

  Food security is one of the most researched social determinants of health (SDoH), however, there is a lack of literature on the impact of food security on cardiovascular disease in pregnancy. The primary objective was to examine the association between food security with hypertensive disorders of pregnancy. We performed a cross-sectional analysis of 2019-2022 data from the National Health Interview Survey. The study population included women of childbearing age who were either pregnant or recently pregnant. Logistic regression models were developed to examine the association between food security and hypertensive disorders of pregnancy. Of the 1635 women included in the analysis, the rate of hypertensive disorders  of pregnancy was 11.1% and the rate of low and very low food security was 5.3% and 4.0%, respectively. The prevalence was 5.8% for hyperlipemia, 0.3% for cardiovascular disease, and 10.5% for diabetes mellitus. The odds of hypertensive disorders of pregnancy were statistically significantly increased among women with low food security compared to women with high food security (odds ratio [OR] 2.40, 95% confidence interval [CI]: 1.19-4.81) after adjusting for age, race, ethnicity, insurance status, body mass index, hyperlipidemia, diabetes mellitus, and cardiovascular disease. Further studies are needed to elucidate the causes of hypertensive disorders of pregnancy and interventions to address including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and food pantries, as it may be more feasible to address issues of food security among pregnant women.

  View details for DOI 10.1111/jch.14952

  View details for Web of Science ID 001378664400001

  View details for PubMedID 39686846

  View details for PubMedCentralID PMC11967692

• Diversity engagement is associated with lower burnout among anesthesia providers. JCA Advances Whiteleather, J. C., Rosario-Rivera, B., Haruna, A., Munoz-Valencia, A., Ondecko-Ligda, K., Vogt, K. M., Ibarra, A. J. 2024; 1 (3-4)

  Abstract

  The high prevalence of burnout among anesthesia providers is a well-established, multifactorial problem that deserves systematic attention and action. This study aimed to identify how perceptions of institutional diversity engagement are associated with burnout and perceived stress among anesthesia personnel.Survey-based prospective cross-sectional study.Anesthesiology department that encompasses community and academic hospitals in a large healthcare system.One-hundred and sixty anesthesiology department employees over 18 years of age (i.e. attending physicians, trainees, advanced practice providers and others).A web-based survey with 39 questions measured: demographics, diversity engagement, burnout, and perceived stress. The primary objective was to assess the association of burnout and diversity engagement and the mediating effect of perceived stress in this relationship. Our secondary objective was to measure the prevalence of burnout, diversity engagement, and perceived stress. Burnout, diversity engagement, and perceived stress were measured using a validated two-item survey developed from the Maslach Burnout Inventory-Human Services Survey, the 22-item Diversity Engagement Survey (DES), and the Perceived Stress Scale (PSS-4), respectively.Mean scores were 4.4 (SD 3.2) for burnout, 78.3 (SD 14.3) for DES, and 4.8 (SD 2.6) for perceived stress. Higher DES score predicted lower burnout (β = -0.11 [95% CI -0.14, -0.08], P < 0.001) and lower perceived stress (β = -0.05 [95% CI -0.08, -0.03], P < 0.001). Mediation analysis estimated the total effect of burnout (β = -0.10, P < 0.001), which comprised the direct effect of diversity engagement (β = -0.08, P < 0.001) and indirect effect of perceived stress (β = -0.02, P = 0.0048).The perception of increased institutional diversity engagement is associated with reduced burnout among anesthesia providers, in part due to a reduction in perceived stress. Implementing interventions at the leadership level that improve diversity engagement may reduce the negative effects of perceived stress and burnout, potentially improving patient care.

  View details for DOI 10.1016/j.jcadva.2024.100027

  View details for PubMedID 41552008

  View details for PubMedCentralID PMC12810883

• Association Between Hypertensive Disorders of Pregnancy and Interval Neurocognitive Decline: An Analysis of the Hispanic Community Health Study/Study of Latinos OBSTETRICS AND GYNECOLOGY Ibarra, A. J., Butters, M. A., Catov, J. M., Ackenbom, M. F. 2024; 144 (5): e107-e108

  View details for DOI 10.1097/AOG.0000000000005737

  View details for Web of Science ID 001341353700001

  View details for PubMedID 39419508

• Neighborhood disadvantage and general anesthesia utilization in cesarean delivery: a retrospective analysis AJOG GLOBAL REPORTS Ibarra, A. J., Campion, H., Canales, C., Burton, B. N., Munoz, A., White, R. S., Li, R., Balasubramani, G. K., Catov, J. M. 2024; 4 (4): 100407

  Abstract

  Neighborhood disadvantage, a social driver of health (SDOH), has been associated with adverse perinatal outcomes; yet little is known about its association with anesthetic choice.The purpose of this study is to assess the association of neighborhood disadvantage and anesthetic choice for cesarean deliveries. We hypothesize that people from the most disadvantaged neighborhoods are more likely to receive general anesthesia for cesarean deliveries compared to those from the most advantaged neighborhoods.This single-center retrospective cohort study identified index cesarean deliveries performed between 2008 and 2017. People were categorized into no, low, moderate, and high disadvantage neighborhood using the area deprivation index. The odds of receiving general anesthesia versus neuraxial anesthesia (epidural, spinal, or combined spinal-epidural) were compared using logistic regression models.Of the 16,351 people with cesarean deliveries, 96.0% received neuraxial versus 4.0% general anesthesia. The rates of general anesthesia were 6.3%, 4.2%, 3.1%, and 2.4% for the high, moderate, low, and no disadvantage groups (P<.001), respectively. Indications for general anesthesia by obstetric indication were different by neighborhood disadvantage (P<.001), but no differences were observed by contraindications of neuraxial anesthesia (P=.091). Compared to the no disadvantage group, the high disadvantage group had higher odds of general anesthesia (aOR 2.0, 95% CI (1.5 to 2.7), P<.001). Results were unchanged after evaluating people in labor only.People from disadvantaged neighborhoods are more likely to receive general anesthesia for cesarean deliveries, even after considering clinical features. The general anesthesia rate is a meaningful benchmark in obstetric anesthesia that may contribute to disparities.

  View details for DOI 10.1016/j.xagr.2024.100407

  View details for Web of Science ID 001473543900015

  View details for PubMedID 39524695

  View details for PubMedCentralID PMC11550171

• Novel Approach to Identify Severe Maternal Morbidity Clusters: A Latent Class Analysis AMERICAN JOURNAL OF PERINATOLOGY Ibarra, A. J., Lopa, S. H., Phan, B. N., Himes, K., Butters, M. A., Beck, S., Catov, J. M. 2025; 42 (06): 722-731

  Abstract

  Whether clusters exist within severe maternal morbidity (SMM), a set of life-threatening heterogeneous conditions, is not known. Our primary objective was to identify SMM clusters using a data-driven clustering technique, their associated predictors and outcomes.From 2008 to 2017, we used a delivery database supplemented by state data and medical record abstraction from a single institution in Pennsylvania. To identify SMM clusters, we applied latent class modeling that included 23 conditions defined by 21 Centers for Disease Control SMM indicators, intensive care unit (ICU) admission, or prolonged postpartum length of stay. Logistic regression models estimated risk for SMM clusters and associations between clusters and maternal and neonatal outcomes.Among 97,492 deliveries, 2.7% (N = 2,666) experienced SMM by any of the 23 conditions. Four clusters were identified as archetypes of SMM. Deliveries labeled as Hemorrhage (37.7%, N = 1,004) were characterized by blood transfusions and sickle cell anemia; Critical Care (28.1%, N = 748) by ICU admission and amniotic embolism; Vascular (24.5%, N = 654) by cerebrovascular conditions; and Shock (9.8%, N = 260) by ventilatory support and shock. Hypertensive disorders of pregnancy, depression, and Medicaid insurance were associated with Shock cluster. People in all clusters had a high risk of maternal death within 1 year (odds ratio: 12.0, 95% confidence interval: 6.2-23). Infants born to those in the shock cluster had the highest odds of neonatal death, low Apgar scores, and neonatal ICU admission.We identified four novel SMM clusters that may help understand the collection of conditions defining SMM, underlying pathways and the importance of comorbidities such as depression and social determinants of health markers that amplify the well-established risk factors for SMM such as hypertensive disorders of pregnancy. · A total of 2.7% of deliveries experienced SMM events.. · There are four distinct SMM clusters: Hemorrhage, Critical Care, Vascular, and Shock.. · Not all SMM clusters bear the same risk for adverse perinatal outcomes..

  View details for DOI 10.1055/a-2418-9955

  View details for Web of Science ID 001331019900004

  View details for PubMedID 39379025

  View details for PubMedCentralID PMC11975718

• Safety of regional anesthesia for patients with pre-existing ulnar neuropathy undergoing decompressive surgery REGIONAL ANESTHESIA AND PAIN MEDICINE Tarnasky, A., Moghalu, T., McNulty, C., Shah, N., Ibarra, A., Orebaugh, S. 2024

  View details for DOI 10.1136/rapm-2024-105781

  View details for Web of Science ID 001294260300001

  View details for PubMedID 39160091

• Perspectives on Ethnic and Language Diversity in Perioperative Neurocognitive Disorders ANESTHESIA AND ANALGESIA Canales, C., Ibarra, A. J., Burton, B. N., Cole, D. J., Whittington, R., Cannesson, M. 2023; 137 (4): 782-787

  View details for DOI 10.1213/ANE.0000000000006656

  View details for Web of Science ID 001081442700018

  View details for PubMedID 37712470

  View details for PubMedCentralID PMC10513730

• Translational research updates in female health anesthesiology: a narrative review. Annals of translational medicine Ibarra, A. J., Roman, K., Nguyen, E., Yates, M. E., Nicholas, A., Lim, G. 2023; 11 (10): 357

  Abstract

  Background and Objective: Females represent 49.6% of the global population and constitute a significant proportion of surgical patients and hospital admissions. Little is known about the bi-directional effects of sex and anesthetics or the impact of anesthetic interventions on long-term female health outcomes. Sex differences in pain pathways can influence pain experience and treatment effectiveness. The impact of anesthetic management on the recurrence of breast cancer is poorly understood, as are the long-term consequences of cardiovascular disease and safe and effective treatments in pregnancy. This review aims to outline recent advances in translational science in female health anesthesiology research and highlight critical research opportunities in pain, cancer outcomes, and cardiovascular disorders.Methods: We searched PubMed and summarized relevant articles published in English between December 2021 and June 2022.Key Content and Findings: Studies reveal sex differences in pain pathways and highlight the importance of sex as a biological variable in experimental designs and translational medicine. Sex differences have also been observed in side effects attributed to opioid analgesics. We summarize some of the neural circuits that might underlie these differences. In the perioperative setting, specific anesthetics are implicated in metastatic seeding potential and acute and chronic pain outcomes, suggesting the importance of anesthetic selection in comprehensive care during oncologic surgery. In the peridelivery setting, preeclampsia, a cardiovascular disorder of pregnancy, affects maternal outcomes; however, biomarkers can risk-stratify females at risk for preeclampsia and hold promise for identifying the risk of adverse neurological and other health outcomes.Conclusions: Research that builds diagnostic and predictive tools in pain and cardiovascular disease will help anesthesiologists minimize sex-related risks and side effects associated with anesthetics and peri-hospital treatments. Sex-specific anesthesia care will improve outcomes, as will the provision of practical information to patients and clinicians about the effectiveness of therapies and behavioral interventions. However, more research studies and specific analytic plans are needed to continue addressing sex-based outcomes in anesthesiology.

  View details for DOI 10.21037/atm-22-3547

  View details for PubMedID 37675293

• Review of racial/ethnic disparities in obstetrics-related anesthesia administration and pain management PAIN MANAGEMENT Khusid, E., Lui, B., Ibarra, A., Villegas, K., White, R. S. 2023; 13 (7): 415-422

  Abstract

  While racial/ethnic disparities in maternal outcomes including mortality and severe maternal morbidity are well documented, there is limited information on disparities in obstetric anesthesia practices. This paper reviews literature on racial/ethnic disparities in peripartum anesthesia administration and postpartum pain management. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric anesthesia care including neuraxial administration for vaginal labor pain, neuraxial versus general anesthesia for cesarean delivery, post neuraxial anesthesia complications, postpartum pain management and postdural puncture headache treatment practices. However, many studies are dated or have limited data from single institutions or states. More research on nation-wide racial/ethnic disparities in obstetric anesthesia is needed to understand its broader practice and management in the USA.

  View details for DOI 10.2217/pmt-2023-0034

  View details for Web of Science ID 001045067000001

  View details for PubMedID 37565312

• Longitudinal cognitive evaluation before and after delivery among people with preeclampsia AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM Ibarra, A. J., Butters, M. A., Lim, G., Jeyabalan, A., Li, R., Balasubramani, G. K., Catov, J. M. 2023; 5 (7): 100966

  Abstract

  Cognitive impairments related to preeclampsia after pregnancy have been reported; however, it is not known if weaknesses in cognition occur before and shortly after delivery.This study aimed to assess the feasibility of longitudinal cognitive testing before and after delivery, and to investigate whether those with preeclampsia have cognitive weaknesses during the third trimester of pregnancy and at 1 and 3 months postpartum. We hypothesized that people with preeclampsia would have lower cognition scores across all time points compared with normotensive people.This longitudinal, prospective, observational study in a single institution enrolled people (N=30) at ≥28 weeks of gestation with preeclampsia (N=16) or normotension (N=14). People with chronic hypertension, neurologic or developmental disabilities, moderate or severe depression or anxiety, or current substance use were excluded. Subjective (Everyday Cognition Scale) and objective assessment of executive function (Stroop Color-Word Interference Test, Trail-Making Test), attention and working memory (Digit Span subtest), and information processing speed (Digit Symbol Substitution Test) was conducted, and Z-scores were calculated. Baseline characteristics (eg, prepregnancy body mass index) were collected from the medical record. Generalized linear models were used to estimate associations.We enrolled 37% (30/81) of eligible people and retained 80% (24/30) and 53% (16/30) at 1 and 3 months postpartum, respectively. People with preeclampsia reported more memory problems (ß=0.87; 95% confidence interval, 0.44-1.31), and scored worse on attention and working memory (ß=-0.94; 95% confidence interval, -1.42 to -0.45) and executive function (Stroop test ß=-0.86; 95% confidence interval, -1.53 to -0.19) domains compared with normotensive people after adjusting for time, age, education, and prepregnancy body mass index.Longitudinal assessment of cognition in pregnant preeclamptic and normotensive people is feasible. People with preeclampsia reported worse subjective memory and had lower scores in attention, working memory, and executive function.

  View details for DOI 10.1016/j.ajogmf.2023.100966

  View details for Web of Science ID 001003221000001

  View details for PubMedID 37084869

  View details for PubMedCentralID PMC10876122

• Association between labor and delivery pain and postpartum pain with symptoms and clinical diagnosis of postpartum depression in patients with overweight and obesity ARCHIVES OF GYNECOLOGY AND OBSTETRICS Rajabaliev, E., LaSorda, K., Ibarra, A., Kenkre, T., Levine, M. D., Lim, G. 2023; 307 (5): 1441-1449

  Abstract

  Childbirth pain has been associated with the risk for postpartum depression. However, existing studies have been limited by the use of depression screening tools as outcomes, and none to date have used a structured clinical interview for DSM-V (SCID), which is considered the gold standard for psychiatric diagnoses. This study aimed to quantify the relationships between labor and postpartum pain and postpartum depression diagnosis detected by SCID, as well as depression symptoms detected by the Center for Epidemiological Studies Depression Scale (CESD) screening tool, among a high-risk cohort.The study was a secondary analysis of a prospective observational study of a cohort of women enriched for high risk for depression, i.e., pregnant women originally enrolled in a prospective study investigating factors leading to excessive gestational weight gain. Subjects were assessed prospectively for depression using both SCID and CESD at the third trimester and at 6 months postpartum. Overweight and obesity were defined as pre-gravid body mass index (BMI) ≥ 25 kg/m2. Both vaginal and cesarean deliveries were included in the cohort. Pain scores (0-10 numeric rating scale) during childbirth and after delivery were correlated with CESD and SCID. Propensity score matching was performed with propensity groups defined as those with low-moderate postpartum pain and those with high postpartum pain. The relationships between pain measures and 6-month postpartum depression diagnosis by SCID, and between pain measures and 6-month postpartum depression symptoms by CESD, were assessed by unweighted logistic regression and by logistic regression weighted by propensity score derived by average treatment effect (ATE) adjusted for baseline covariates.There were 237 subjects in the cohort for analysis. Labor and postpartum pain were not associated with depression diagnosis by SCID at 6 months postpartum. However, postpartum pain, but not labor pain, was associated with depressive symptoms on the CESD at 6 months postpartum. Women with higher maximum postpartum pain scores had significantly higher odds of developing clinically significant postpartum depressive symptoms at 6 months, compared to those with lower pain scores in the unweighted model (OR: 1.3, 95% CI 1.0, 1.5; P = 0.005) and ATE-weighted models (OR: 1.2, 95% CI 1.0, 1.5; P = 0.03). Consistent with prior work, SCID and CESD were strongly associated, and 92.9% (13/14) of participants with postpartum depression diagnosis by 6-month SCID also showed high CESD symptomology, P < 0.0001).Although labor and postpartum pain were not associated with clinical diagnosis of depression (SCID) at 6 months postpartum, postpartum pain was linked to 6-month postpartum depression symptoms. Depressive symptoms are more likely to be exhibited in women with higher postpartum pain, potentially reflecting poorer birth recovery. The contribution of postpartum pain and depressive symptoms to overall patterns of poor recovery after childbirth should be assessed further.

  View details for DOI 10.1007/s00404-022-06625-x

  View details for Web of Science ID 000805894400002

  View details for PubMedID 35665850

  View details for PubMedCentralID PMC9719570

• Anesthesia-Associated Racial Disparities in Severe Maternal Morbidity After Cesarean Delivery Ibarra, A., Lim, G., Butters, M., Sadhasivam, S., Catov, J. LIPPINCOTT WILLIAMS & WILKINS. 2022: 656-657

  View details for Web of Science ID 000840283000261

• Preoperative Systemic Immune-Inflammation Index Predicts Recurrence after Resection of Pancreatic Neuroendocrine Tumors Alvikas, J., Zheng, J., Rieser, C., Ibarra, A. J., Zureikat, A. H., Paniccia, A. ELSEVIER SCIENCE INC. 2021: S152-S153

  View details for Web of Science ID 000718303100281

• The impact of socioeconomic status in patients with left ventricular assist devices (LVADs) JOURNAL OF CARDIAC SURGERY Ibarra, A., Howard-Quijano, K., Hickey, G., Garrard, W., Thoma, F., Mahajan, A., Kilic, A. 2021; 36 (10): 3501-3508

  Abstract

  Socioeconomic status (SES) can be a powerful predictor of adverse outcomes among heart failure patients but its impact on survival and readmission following left ventricular assist device (LVAD) implantation surgery is poorly understood. We investigated if the LVAD recipients from more deprived neighborhoods experienced higher mortality and readmission rate after device implantation as compared to those from less deprived areas.This is a single center, retrospective analysis evaluating adults who received Heartmate III and Heartware HVAD implants between 2009 and 2018. SES indicators were area of deprivation index (ADI), race and income. Our cohort was grouped by ADI quartiles from least deprived (Q1), Q2, Q3 to the most deprived (Q4). Outcomes included overall mortality and readmission following surgery.A total of 191 patients were included in the study. Demographics by SES indicators demonstrated that least deprived (Q1) patients were older than the most deprived (65 vs. 57, p < .01), African-American patients originated from more deprived neighborhoods than Caucasians (ADI 87 vs. 62, p < .001), and high-income patients had higher preoperative BUN and creatinine. Outcome differences included a decreased risk of death in most deprived patients (Q4) compared to the least deprived (Q1), however after adjusting for age, LVAD indication, and INTERMACS profile this was no longer significant. No differences in survival or readmission by race or income was observed CONCLUSION: SES does not independently impact survival and readmission after Heartware HVAD and Heartmate III LVAD implantation. More studies are needed to evaluate if other SES factors affect these outcomes.

  View details for DOI 10.1111/jocs.15794

  View details for Web of Science ID 000672046000001

  View details for PubMedID 34241917

  View details for PubMedCentralID PMC8434999

• Intraoperative Remifentanil Infusion and Postoperative Pain Outcomes After Cardiac Surgery-Results from Secondary Analysis of a Randomized, Open-Label Clinical Trial Subramaniam, K., Ibarra, A., Ruppert, K., Mallikarjun, K., Orebaugh, S. W B SAUNDERS CO-ELSEVIER INC. 2021: 458-466

  Abstract

  Report of secondary pain outcomes from a prospective, randomized, open-label clinical trial that compared remifentanil and fentanyl on perioperative hyperglycemic response in cardiac surgery.Single institution, tertiary university hospital.The study comprised 116 adult elective cardiac surgical patients.Participants were randomly assigned to receive either intermittent fentanyl boluses (F) or continuous remifentanil infusion (R) intraoperatively.Postoperative pain was evaluated with pain scores every 6 hours for 48 hours. Pain threshold to mechanical stimuli was measured around the sternotomy incision at 48 and 96 hours. The development of chronic pain was assessed using the numeric rating scale at 1, 3, 6, and 12 months after discharge. The final analysis included 106 patients. Pain scores and wound hyperalgesia were not significantly different postoperatively between the groups. The incidence of chronic pain at 3 months was comparable in both groups (61% in group F v 58% in group R; p = 0.79). Pain of more-than-mild degree was seen in 13 (32%) patients in group F and 8 (19%) in group R (p = 0.25) at 3 months. Median pain scores were not significantly different between the groups at 1, 3, 6, and 12 months after discharge from the hospital.The present study's findings suggested that intraoperative remifentanil infusion does not significantly worsen pain outcomes in patients undergoing elective cardiac surgery.

  View details for DOI 10.1053/j.jvca.2020.08.064

  View details for Web of Science ID 000601039600018

  View details for PubMedID 32962934

  View details for PubMedCentralID PMC9423078

• Echocardiographic Guidance of AMPLATZER Amulet Left Atrial Appendage Occlusion Device Placement SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA Subramaniam, K., Ibarra, A., Boisen, M. L. 2019; 23 (2): 248-255

  Abstract

  In this report, we provided details of periprocedural echocardiographic guidance for patients undergoing Amplatzer-Amulet device left atrial closure. Familiarity with left atrial appendage (LAA) occlusion devices and the required left atrial examination and measurements are key before device placement. Device placement is assisted by transesophageal echocardiography (TEE) and fluoroscopy, but TEE will be the main guide for patients with renal insufficiency in whom contrast dye use needs to be minimal. TEE is also used to confirm LAA occlusion with the device and finally detect complications throughout the procedure and into the postoperative period.

  View details for DOI 10.1177/1089253218758463

  View details for Web of Science ID 000468994200011

  View details for PubMedID 29484953