Percutaneous left atrial appendage closure for stroke prevention.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Oral anticoagulation (OAC) is standard for stroke prevention in atrial fibrillation (AF) but carries a high bleeding risk.
• Percutaneous left atrial appendage (LAA) closure is an alternative for AF patients with contraindications to OAC.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous LAA closure for stroke prevention in high-risk AF patients.
• To describe procedural experience and outcomes in a cohort of AF patients.

Main Methods:

• Percutaneous LAA closure was performed in 42 AF patients with high stroke (CHADS-VASc 4.5±1.4) and bleeding (HAS-BLED 3.7±0.9) risks.
• Intracerebral bleeding history was the primary indication for LAA closure.

Main Results:

• Successful LAA closure was achieved in 41 of 42 patients, with one major gastrointestinal bleeding complication.
• The observed annual stroke and bleeding rate was 2.3%, lower than the predicted rates (5.6% and 7.6%, respectively).
• Incomplete LAA closure occurred in one patient; no device thrombosis was observed during a mean 12.6-month follow-up.

Conclusions:

• Percutaneous LAA closure is a safe and effective strategy for stroke prevention in AF patients with high stroke and bleeding risks.
• Long-term follow-up studies are necessary to support routine clinical adoption of LAA closure.