Radoslaw Litwinowicz1, Magdalena Bartus2, Boguslaw Kapelak1, Piotr Suwalski3, Dhanunjaya Lakkireddy4, Randall J Lee5,6, Krzysztof Bartus1. 1. Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Poland. 2. Department of Pharmacology, Jagiellonian University, Poland. 3. Department of Cardiac Surgery, Central Clinical Hospital of Ministry of Interior, Warsaw, Poland. 4. The Kansas City Heart Rhythm Institute, Overland Park Regional Hospital, University of Kansas, Overland Park, Kansas. 5. Department of Medicine, Division of Cardiac Electrophysiology, University of California San Francisco, San Francisco, California. 6. Cardiovascular Research Institute, Institute for Regeneration Medicine, University of California San Francisco, San Francisco, California.
Abstract
BACKGROUNDS: Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation (AF). The aim of this study was to present long-term clinical outcomes of LAAO in patients with a high risk of stroke and thromboembolic events (CHA2 DS2 -VAS-score ≥ 2) and bleeding (HAS-BLED score ≥ 2). MATERIAL AND METHODS: A prospective, single-center study was performed in 120 patients who were screened for LAAO with the LARIAT. Out of these 89 patients were underwent LARIAT placement, were 57 had high risk of thromboembolic and bleeding risk (LAA group). Control Group consisted of patients and 31 who screened out from the LARIAT and did not undergo LAAO. RESULTS: The mean CHA2 DS2 -VAS-score was 3.6 ± 1.5 versus 3.1 ± 1.2 and HAS-BLED score was 3.6 ± 1 versus 3 ± 1 compare LAA group versus control group. There were no thromboembolic events in the LAA group. In the control group thromboembolic events were observed in 9.6% (P = 0.017). Annual mortality rate was 1.8% in LAA group and 3.2% in control group (P < 0.05). Estimated bleeding risk reduction in LAA group was 62.2%. CONCLUSIONS: Long-term data confirmed that left atrial appendage closure with the LARIAT device is an effective and safe treatment in nonvalvular AF patients with high risk of stroke and bleeding.
BACKGROUNDS: Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation (AF). The aim of this study was to present long-term clinical outcomes of LAAO in patients with a high risk of stroke and thromboembolic events (CHA2 DS2 -VAS-score ≥ 2) and bleeding (HAS-BLED score ≥ 2). MATERIAL AND METHODS: A prospective, single-center study was performed in 120 patients who were screened for LAAO with the LARIAT. Out of these 89 patients were underwent LARIAT placement, were 57 had high risk of thromboembolic and bleeding risk (LAA group). Control Group consisted of patients and 31 who screened out from the LARIAT and did not undergo LAAO. RESULTS: The mean CHA2 DS2 -VAS-score was 3.6 ± 1.5 versus 3.1 ± 1.2 and HAS-BLED score was 3.6 ± 1 versus 3 ± 1 compare LAA group versus control group. There were no thromboembolic events in the LAA group. In the control group thromboembolic events were observed in 9.6% (P = 0.017). Annual mortality rate was 1.8% in LAA group and 3.2% in control group (P < 0.05). Estimated bleeding risk reduction in LAA group was 62.2%. CONCLUSIONS: Long-term data confirmed that left atrial appendage closure with the LARIAT device is an effective and safe treatment in nonvalvular AFpatients with high risk of stroke and bleeding.
Authors: Karolina Pawelkowska; Stanislaw Bartus; Robert Sobczynski; Michal Medrzycki; Grzegorz Grudzien; Grzegorz Filip; Bartosz Cierpikowski; Krzysztof Bartus; Boguslaw Kapelak Journal: Kardiochir Torakochirurgia Pol Date: 2022-01-09