Left atrial appendage exclusion: State‐of‐the‐art
- 23 March 2010
- journal article
- review article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 75 (5), 806-813
- https://doi.org/10.1002/ccd.22344
Abstract
It is postulated that the source of thromboembolism in 90% of patients with non‐valvular atrial fibrillation (AF) arises from the left atrial appendage (LAA). Anticoagulation with warfarin is the standard medical therapy for stroke prevention in patients with AF. However, chronic warfarin therapy is contraindicated in 14 to 44% of patients with AF who are at risk for stroke. Mechanical exclusion of the LAA may prevent thrombus formation in the appendage and hence reduce the risk of stroke. Recently, several studies of percutaneous transcatheter delivery of dedicated LAA exclusion devices such as the PLAATO device, Watchman device and the Amplatzer cardiac plug, have shown encouraging results as an alternative to warfarin therapy for selected patients. This article aims to review the current evidence for LAA exclusion in patients with AF.Keywords
This publication has 20 references indexed in Scilit:
- Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-Year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) StudyJACC: Cardiovascular Interventions, 2009
- Percutaneous closure of left atrial appendage to prevent embolic events in high‐risk patients with chronic atrial fibrillationCatheterization and Cardiovascular Interventions, 2009
- Occluding the left atrial appendage: anatomical considerationsHeart, 2008
- Initial Worldwide Experience With the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Atrial FibrillationJournal of the American College of Cardiology, 2007
- ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation–executive summaryEuropean Heart Journal, 2006
- Percutaneous Left Atrial Appendage Transcatheter Occlusion (PLAATO System) to Prevent Stroke in High-Risk Patients With Non-Rheumatic Atrial Fibrillation: Results From the International Multi-Center Feasibility TrialsJournal of the American College of Cardiology, 2005
- Embolic Events and Char Formation During Pulmonary Vein Isolation in Patients with Atrial Fibrillation: Impact of Different Anticoagulation Regimens and Importance of Intracardiac Echo ImagingJournal of Cardiovascular Electrophysiology, 2005
- Cardiac anatomy revisitedJournal of Anatomy, 2004
- Risk FactorsStroke, 1997
- Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillationThe Annals of Thoracic Surgery, 1996