BACKGROUND: Patients with atrial fibrillation (AF) have an increased risk of thromboembolic stroke, dependent on clinical variables. Oral anticoagulation significantly decreases the risk of stroke or embolism, but sometimes this is difficult to manage and may be contraindicated. Approximately 90% of atrial thrombi in nonrheumatic AF are found in the left atrial appendage (LAA). A new device has been developed which allows percutaneous LAA occlusion (PLAATO) and might be an alternative to oral anticoagulation. Feasibility in dogs and humans was described previously. METHODS AND RESULTS: As part of an international multicentre trial, three patients received a percutaneous transcatheter LAA occlusion device. Implantations were performed without general anaesthesia, guided by intracardiac and transoesophageal echocardiography and without major complications. The implantations were well tolerated by the patients, who entered a long-term follow-up to be compared with a historical control group. CONCLUSION: Transseptal percutaneous LAA occlusion is feasible. Its role as an alternative to oral anticoagulation, however, needs to be further defined.
BACKGROUND:Patients with atrial fibrillation (AF) have an increased risk of thromboembolic stroke, dependent on clinical variables. Oral anticoagulation significantly decreases the risk of stroke or embolism, but sometimes this is difficult to manage and may be contraindicated. Approximately 90% of atrial thrombi in nonrheumatic AF are found in the left atrial appendage (LAA). A new device has been developed which allows percutaneous LAA occlusion (PLAATO) and might be an alternative to oral anticoagulation. Feasibility in dogs and humans was described previously. METHODS AND RESULTS: As part of an international multicentre trial, three patients received a percutaneous transcatheter LAA occlusion device. Implantations were performed without general anaesthesia, guided by intracardiac and transoesophageal echocardiography and without major complications. The implantations were well tolerated by the patients, who entered a long-term follow-up to be compared with a historical control group. CONCLUSION: Transseptal percutaneous LAA occlusion is feasible. Its role as an alternative to oral anticoagulation, however, needs to be further defined.
Entities:
Keywords:
atrial fibrillation; left atrial appendage; occluder; thromboembolic risk
Authors: Horst Sievert; Michael D Lesh; Thomas Trepels; Heyder Omran; Antonio Bartorelli; Paola Della Bella; Toshiko Nakai; Mark Reisman; Carlo DiMario; Peter Block; Paul Kramer; Dirk Fleschenberg; Ulrike Krumsdorf; Detlef Scherer Journal: Circulation Date: 2002-04-23 Impact factor: 29.690
Authors: J A Odell; J L Blackshear; E Davies; W J Byrne; C F Kollmorgen; W D Edwards; T A Orszulak Journal: Ann Thorac Surg Date: 1996-02 Impact factor: 4.330