TY - JOUR
T1 - Percutaneous left atrial appendage occlusion in patients with atrial fibrillation and left appendage thrombus
T2 - Feasibility, safety and clinical efficacy
AU - Tarantini, Giuseppe
AU - D'Amico, Gianpiero
AU - Latib, Azeem
AU - Montorfano, Matteo
AU - Mazzone, Patrizio
AU - Fassini, Gaetano
AU - Maltagliati, Anna
AU - Ronco, Federico
AU - Saccï, Salvatore
AU - Cruz-Gonzalez, Ignatio
AU - Ibrahim, Reda
AU - Freixa, Xavier
N1 - Publisher Copyright:
© Europa Digital & Publishing 2018.
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
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U2 - 10.4244/EIJ-D-17-00777
DO - 10.4244/EIJ-D-17-00777
M3 - Article
C2 - 29086706
AN - SCOPUS:85041668243
SN - 1774-024X
VL - 13
SP - 1595
EP - 1602
JO - EuroIntervention
JF - EuroIntervention
IS - 13
ER -