Percutaneous devices for left atrial appendage occlusion: A contemporary review

World Journal of Cardiology
Homam Moussa PachaM Chadi Alraies

Abstract

Patient with atrial fibrillation (AF) are at risk of developing stroke with the left atrial appendage (LAA) being the most common site for thrombus formation. If left untreated, AF is associated with 4 to 5 folds increase in the risk of ischemic stroke in all age groups. About 5% to 15% of AF patients have atrial thrombi on transesophageal echocardiography, and 91% of those thrombi are located in the LAA in patient with nonrheumatic AF. Although oral anticoagulants are the gold-standard treatment for stroke prevention in patients with non-valvular AF, some patients are at high risk of bleeding and deemed not candidates for anticoagulation. Therefore, LAA occlusion (LAAO) has emerged as alternative approach for stroke prevention in those patients. Surgical LAAO is associated with high rate of unsuccessful closure and recommended only in patients with AF and undergoing cardiac surgery. Percutaneous LAAO uses transvenous access with trans-septal puncture and was first tested using the PLAATO device. Watchman is the most common and only Food and Drug Administration (FDA) approved device for LAAO. LAAO using Watchman device is non-inferior to warfarin therapy in preventing ischemic stroke/systemic thromboembolism. However, it is ass...Continue Reading

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Citations

Jun 7, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Ethan FryJeffrey Michel
Feb 23, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Sarah K WestcottJason H Rogers
Jul 28, 2020·Thrombosis and Haemostasis·Wern Yew DingDhiraj Gupta
May 1, 2021·Journal of the Mechanical Behavior of Biomedical Materials·Alissa ZaccariaLorenza Petrini
May 8, 2021·Pacing and Clinical Electrophysiology : PACE·Abdullah HaddadIsaac R Whitman
Aug 19, 2020·Cardiology·Demilade AdedinsewoPragnesh Parikh
Nov 25, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Sridhar R MusukuBrion Winston

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Methods Mentioned

BETA
ICE

Software Mentioned

PLAATO
PREVAIL
RELEXAO

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