Amplatzer left atrial appendage occlusion: single center 10-year experience

Nietlispach, Fabian; Gloekler, Steffen; Krause, René; Shakir, Samera; Schmid, Michael; Khattab, Ahmed A.; Wenaweser, Peter; Windecker, Stephan; Meier, Bernhard (2013). Amplatzer left atrial appendage occlusion: single center 10-year experience. Catheterization and cardiovascular interventions, 82(2), pp. 283-289. Wiley-Blackwell 10.1002/ccd.24872

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OBJECTIVES To report a 10-year single center experience with Amplatzer devices for left atrial appendage (LAA) occlusion. BACKGROUND Intermediate-term outcome data following LAA occlusion are scarce. METHODS Short- and intermediate-term outcomes of patients who underwent LAA occlusion were assessed. All procedures were performed under local aesthesia without transesophageal echocardiography. Patients were discharged on acetylsalicylic acid and clopidogrel for 1-6 months. RESULTS LAA occlusion was attempted in 152 patients (105 males, age 72 ± 10 years, CHA2 DS2 -Vasc-score 3.4 ± 1.7, HAS-BLED-score 2.4 ± 1.2). Nondedicated devices were used in 32 patients (21%, ND group) and dedicated Amplatzer Cardiac Plugs were used in 120 patients (79%, ACP group). A patent foramen ovale or atrial septal defect was used for left atrial access and closed at the end of LAA occlusion in 40 patients. The short-term safety endpoints (procedural complications, bleeds) occurred in 15 (9.8%) and the efficacy endpoints (death, stroke, systemic embolization) in 0 patients. Device embolization occurred more frequently in the ND as compared to the ACP group (5 patients or 12% vs. 2 patients or 2%). Mean intermediate-term follow up of the study population was 32 months (range 1-120). Late deaths occurred in 15 patients (5 cardiovascular, 7 noncardiac, 3 unexplained). Neurologic events occurred in 2, peripheral embolism in 1, and major bleeding in 4 patients. The composite efficacy and safety endpoint occurred in 7% and 12% of patients. CONCLUSION LAA closure may be a good alternative to oral anticoagulation. This hypothesis needs to be tested in a randomized clinical trial to ensure that all potential biases of this observational study are accounted for.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine

UniBE Contributor:

Nietlispach, Fabian; Glökler, Steffen; Krause, René; Shakir, Samera; Khattab, Ahmed Aziz; Wenaweser, Peter Martin; Windecker, Stephan and Meier, Bernhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Judith Liniger

Date Deposited:

24 Mar 2014 07:53

Last Modified:

28 Oct 2015 11:47

Publisher DOI:

10.1002/ccd.24872

PubMed ID:

23412815

Uncontrolled Keywords:

device closure; embolism; interventional closure; left atrial appendage; stroke

BORIS DOI:

10.7892/boris.41683

URI:

https://boris.unibe.ch/id/eprint/41683

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