Transcatheter left atrial appendage occlusion

Cardiol Clin. 2013 Aug;31(3):363-84. doi: 10.1016/j.ccl.2013.05.008.

Abstract

Occlusion of the left atrial appendage (LAA) may reduce the risk of stroke in patients with atrial fibrillation (AF). Trials comparing LAA occlusion to warfarin anticoagulation in patients with nonvalvular AF showed a reduction in hemorrhagic stroke, although an increase in safety events due to procedural complications. Long-term follow-up suggests possible superiority of LAA occlusion due to fewer strokes and bleeding events. The superior dosing and safety profiles of the novel oral anticoagulants raise the accepted threshold for safety and efficacy of LAA occlusion procedures, and underscore the need for randomized studies comparing LAA occlusion with these newer anticoagulants.

Keywords: Atrial fibrillation; Left atrial appendage; Occlusion; Transcatheter.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • Anticoagulants
  • Atrial Appendage / pathology*
  • Atrial Fibrillation / pathology
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization / methods*
  • Contraindications
  • Echocardiography
  • Female
  • Heart Diseases / pathology
  • Hemorrhage / prevention & control
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Patient Selection
  • Prosthesis Design
  • Septal Occluder Device*
  • Stroke / pathology
  • Stroke / prevention & control*
  • Thrombosis / pathology

Substances

  • Anticoagulants