Percutaneous left atrial appendage occlusion in patients with atrial fibrillation and left appendage thrombus: Feasibility, safety and clinical efficacy

Giuseppe Tarantini, Gianpiero D'Amico, Azeem Latib, Matteo Montorfano, Patrizio Mazzone, Gaetano Fassini, Anna Maltagliati, Federico Ronco, Salvatore Saccï, Ignatio Cruz-Gonzalez, Reda Ibrahim, Xavier Freixa

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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 centreïs 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.

Original languageEnglish (US)
Pages (from-to)1595-1602
Number of pages8
JournalEuroIntervention
Volume13
Issue number13
DOIs
StatePublished - Jan 2018
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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