Related Experiment Video
Updated: Aug 6, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
[Feasibility of percutaneous exclusion of the left atrial appendage: results of 11 cases]
D Himbert1, A Cachier, E Brochet
1Départment de Cardiologie, Hôpital Bichat, Paris. dominique.himbert@bch.ap-hop-paris.fr
Insights
Percutaneous left atrial appendage exclusion using the PLAATO System offers a new stroke prevention method for atrial fibrillation patients unable to use anticoagulants. This minimally invasive procedure shows technical feasibility and encouraging short-term results.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Atrial fibrillation increases stroke risk via cerebral embolism.
- Anticoagulant therapy is the standard stroke prevention, but not suitable for all patients.
- Left atrial appendage (LAA) exclusion is an alternative strategy.
Purpose of the Study:
- To evaluate the feasibility and safety of percutaneous LAA exclusion using the PLAATO System.
- To assess the efficacy of LAA exclusion in patients with contraindications to anticoagulation.
Main Methods:
- A series of 11 high-risk atrial fibrillation patients with contraindications to anticoagulants underwent LAA exclusion.
- The PLAATO System was implanted under general anesthesia, radioscopy, and transesophageal echocardiographic guidance.
- Patients received aspirin and clopidogrel peri-procedurally.
Main Results:
- Successful LAA exclusion was achieved in 9 out of 11 patients (82%).
- One patient experienced transient ST elevation requiring angioplasty; no other immediate complications occurred.
- Echocardiographic and angiographic criteria for successful exclusion were met in all implanted patients.
- One stroke recurrence was noted at two months, with no evidence of prosthesis issues.
Conclusions:
- Percutaneous LAA exclusion with the PLAATO System is technically feasible for selected atrial fibrillation patients.
- The procedure demonstrates encouraging short-term safety and efficacy.
- Long-term effectiveness in preventing thromboembolic events requires further investigation.
Abstract:
Atrial fibrillation is associated with a risk of cerebral embolism, the only proven effective prevention of which is anticoagulant therapy. There is no known alternative in cases with contra-indications to this treatment. Percutaneous exclusion of the left atrial appendage by the implantation of a prosthesis (PLAATO System, ev3 Inc., Plymouth, Minnesota) is a new approach to the prevention of these complications. The authors report the results observed in a series of 11 consecutive patients (7 men, mean age 72 +/- 9 years) in whom this procedure was proposed. All patients had atrial fibrillation for over 3 months, were at high risk and had contra-indications to oral anticoagulants. The implantation of the prosthesis was performed after treatment with aspirin and clopidogrel, under general anaesthesia radioscopy and transoesophageal echocardiographic guidance with success in 9 cases (1 implantation refused in the catheter laboratory and 1 failure). The only complication observed was transient ST elevation treated by emergency angioplasty. The echographic and angiographic criteria of success of left atrial appendage exclusion were fulfilled in all implanted patients. The hospital course was uncomplicated. One recurrence of stroke was observed at the second month: transoesophageal echocardiography confirmed the absence of thrombosis, of migration of the prosthesis and its impermeability in all the patients. After 7 +/- 5 months' follow-up, no other adverse event was observed. This new procedure is technically feasible. Despite encouraging results, its long-term efficacy in the prevention of thromboembolic complications of atrial fibrillation remains to be demonstrated.
