Percutaneous Left Atrial Appendage Closure: Current Devices and Clinical Outcomes

Circ Cardiovasc Interv. 2017 Nov;10(11):e005359. doi: 10.1161/CIRCINTERVENTIONS.117.005359.

Abstract

Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation. In this article, we provide an updated overview of current transcatheter left atrial appendage closure devices and review the results associated with left atrial appendage closure, focusing on procedural and late outcomes, and pointing to future directions.

Keywords: anticoagulants; atrial appendage; atrial fibrillation; embolism; prevalence.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Atrial Appendage / physiopathology*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Contraindications, Drug
  • Humans
  • Prosthesis Design*
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / prevention & control*
  • Thromboembolism / diagnosis
  • Thromboembolism / epidemiology
  • Thromboembolism / prevention & control*
  • Treatment Outcome

Substances

  • Anticoagulants