Interventional and surgical occlusion of the left atrial appendage.

Caliskan, Etem; Cox, James L; Holmes, David R; Meier, Bernhard; Lakkireddy, Dhanunjaya R; Falk, Volkmar; Salzberg, Sacha P; Emmert, Maximilian Y (2017). Interventional and surgical occlusion of the left atrial appendage. Nature reviews - cardiology, 14(12), pp. 727-743. Nature Publishing Group 10.1038/nrcardio.2017.107

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With a steadily increasing prevalence, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and an independent risk factor for stroke caused by thromboembolic events. The left atrial appendage (LAA) is the primary source of thromboemboli in patients with nonvalvular AF who have a stroke. Novel strategies (such as mechanical and nonpharmacological intervention) targeting the LAA in patients with AF for stroke prevention have become a major focus during the past decade. Some devices for percutaneous LAA occlusion are supported by robust clinical data obtained from randomized trials or large registries, and are a valid alternative to pharmacological stroke prevention. However, the incidence of periprocedural complications and the presence of device-related thrombi or residual LAA leaks, whose long-term clinical implications are still unknown, are limiting factors in wider acceptability of these techniques. In this Review, we discuss the available techniques for LAA occlusion in patients with nonvalvular AF at high risk of stroke. We describe the pharmacological and mechanical approaches to LAA occlusion, and provide the current clinical evidence for various strategies. We particularly focus on the current management of the LAA, and discuss the challenges and future implications of the available approaches to LAA occlusion.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-5010

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Luana Cauto

Date Deposited:

26 Feb 2018 15:10

Last Modified:

23 Oct 2019 23:15

Publisher DOI:

10.1038/nrcardio.2017.107

PubMed ID:

28795688

BORIS DOI:

10.7892/boris.111204

URI:

https://boris.unibe.ch/id/eprint/111204

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