AIMS: The aim of this study was to investigate the feasibility, safety and efficacy of percutaneous closure for prevention of thromboembolic events in patients with atrial fibrillation (AF) and left atrial appendage (LAA) thrombus. METHODS AND RESULTS: The study included consecutive patients with AF and LAA thrombus who underwent transcatheter occlusion in eight high-volume centres. Clinical and transoesophageal echocardiography (TEE) follow-up was carried out as per each centre's protocol. Twenty-eight patients were included. The location of the LAA thrombus was distal in 100% of cases. Technical and procedural success was achieved in all patients. A cerebral protection device was used in six cases. There were no periprocedural adverse events. Follow-up was complete in all patients (total 32 patient-years). No death or thromboembolic events were reported. There was one major bleeding during follow-up. Among the 23 patients undergoing TEE, device thrombosis was present in one patient. No significant peri-device leaks were observed. CONCLUSIONS: In this multicentre study, percutaneous closure in selected patients with distal LAA thrombus appears to be feasible and safe, and is associated with high procedural success and a favourable outcome for the prevention of AF-related thromboembolism. Special implant techniques avoiding mechanical mobilisation of the thrombotic mass and the liberal use of cerebral embolic protection devices are recommended.
AIMS: The aim of this study was to investigate the feasibility, safety and efficacy of percutaneous closure for prevention of thromboembolic events in patients with atrial fibrillation (AF) and left atrial appendage (LAA) thrombus. METHODS AND RESULTS: The study included consecutive patients with AF and LAA thrombus who underwent transcatheter occlusion in eight high-volume centres. Clinical and transoesophageal echocardiography (TEE) follow-up was carried out as per each centre's protocol. Twenty-eight patients were included. The location of the LAA thrombus was distal in 100% of cases. Technical and procedural success was achieved in all patients. A cerebral protection device was used in six cases. There were no periprocedural adverse events. Follow-up was complete in all patients (total 32 patient-years). No death or thromboembolic events were reported. There was one major bleeding during follow-up. Among the 23 patients undergoing TEE, device thrombosis was present in one patient. No significant peri-device leaks were observed. CONCLUSIONS: In this multicentre study, percutaneous closure in selected patients with distal LAA thrombus appears to be feasible and safe, and is associated with high procedural success and a favourable outcome for the prevention of AF-related thromboembolism. Special implant techniques avoiding mechanical mobilisation of the thrombotic mass and the liberal use of cerebral embolic protection devices are recommended.
Authors: Mohammed Osman; Tatiana Busu; Khansa Osman; Safi U Khan; Matthew Daniels; David R Holmes; Mohamad Alkhouli Journal: JACC Clin Electrophysiol Date: 2020-01-29
Authors: Luis Marroquin; Gabriela Tirado-Conte; Radosław Pracoń; Witold Streb; Hipolito Gutierrez; Giacomo Boccuzzi; Dabit Arzamendi-Aizpurua; Ignacio Cruz-González; Juan Miguel Ruiz-Nodar; Jung-Sun Kim; Xavier Freixa; Jose Ramon Lopez-Minguez; Ole De Backer; Rafael Ruiz-Salmeron; Antonio Dominguez; Angela McInerney; Vicente Peral; Rodrigo Estevez-Loureiro; Eduard Fernandez-Nofrerias; Afonso B Freitas-Ferraz; Francesco Saia; Zenon Huczek; Livia Gheorghe; Pablo Salinas; Marcin Demkow; Jose R Delgado-Arana; Estefania Fernandez Peregrina; Zbibniew Kalarus; Ana Elvira Laffond; Yangsoo Jang; Jose Carlos Fernandez Camacho; Oh-Hyun Lee; Jose M Hernández-Garcia; Caterina Mas-Llado; Berenice Caneiro Queija; Ignacio J Amat-Santos; Maciej Dabrowski; Josep Rodés-Cabau; Luis Nombela Franco Journal: Heart Date: 2022-06-24 Impact factor: 7.365