Percutaneous Left Atrial Appendage€Closure
نویسنده
چکیده
Ma Percutaneous left atrial appendage closure technology for stroke prevention in patients with atrial fibrillation has significantly advanced in the past 2 decades. Several devices are under clinical investigation, and a few have already received Conformité Européene (CE)-mark approval and are available in many countries. The WATCHMAN device (Boston Scientific, Natick, Massachusetts) has the most supportive data and is under evaluation by the U.S. Food and Drug Administration for warfarin-eligible patients. The Amplatzer Cardiac Plug (St. Jude Medical, Plymouth, Minnesota) has a large real-world experience over the past 5 years, and a randomized trial comparing Amplatzer Cardiac Plug with the WATCHMAN device is anticipated in the near future. The Lariat procedure (SentreHEART Inc., Redwood City, California) has also gained interest lately, but early studies were concerning for high rates of serious pericardial effusion and major bleeding. The current real-world experience predominantly involves patients who are not long-term anticoagulation candidates or who are perceived to have high bleeding risks. This pattern of practice is expected to change when the U.S. Food and Drug Administration approves the WATCHMAN device for warfarin-eligible patients. This paper reviews in depth the procedural techniques, safety, and outcomes of the current leading devices. (J Am Coll Cardiol Intv 2014;7:1205–20) © 2014 by the American College of Cardiology Foundation.
منابع مشابه
Percutaneous Closure of the Left Atrial Appendage.
This article reviews the published evidence on stroke prevention with percutaneous closure of the left atrial appendage and provides comparative insight into the various left atrial appendage closure devices currently in development.
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Ischemic stroke is a common complication of atrial fibrillation (AF). Currently, oral anticoagulant drugs are the most commonly used method of stroke prevention. Left atrial appendage occlusion is thought to be the main source of thrombi in patients with AF. Percutaneous left atrial appendage is a valuable therapeutic option for selected high-risk patients with AF and contraindications for oral...
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