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Percutaneous left atrial appendage closure in AF using Amplatzer Cardiac Plug: First single center experience from
Ranjan K Shetty1, G S Naveen Chandra2, Sumit Agarwal3
1Professor of Cardiology, KMC Manipal, Manipal University, India.
Insights
Percutaneous left atrial appendage (LAA) closure using the Amplatzer Cardiac Plug is a safe and effective alternative for non-valvular atrial fibrillation (AF) patients unsuitable for oral anticoagulation, with no major complications observed.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia, particularly in the elderly, associated with significant mortality and morbidity.
- Oral anticoagulation (OAC) is effective for stroke prevention in AF but carries bleeding risks, leading to underuse or suboptimal dosing.
- Percutaneous left atrial appendage (LAA) closure offers an alternative for patients with OAC contraindications or high bleeding risk.
Purpose of the Study:
- To report the first single-center experience in India of percutaneous LAA closure using the Amplatzer Cardiac Plug.
- To evaluate the safety and efficacy of this procedure in patients with non-valvular AF who cannot tolerate OAC.
- To provide a comprehensive review of the percutaneous LAA closure technique.
Main Methods:
- A single-center study involving 10 patients with non-valvular AF.
- Percutaneous LAA closure was performed using the Amplatzer Cardiac Plug.
- Patients included those with contraindications to OAC, high bleeding risk, or labile INR.
Main Results:
- Successful device deployment in all 10 cases.
- No major perioperative or short-term follow-up complications were reported.
- The study included a review of the LAA closure technique and modifications.
Conclusions:
- Percutaneous LAA closure with the Amplatzer Cardiac Plug is a safe and effective option for selected AF patients in India.
- This procedure provides a viable alternative for stroke risk reduction in patients unable to receive OAC.
- Further experience and data are warranted to establish its role in clinical practice.
Background:
Atrial fibrillation (AF) is one of the most common arrhythmias accounting for significant mortality and morbidity, especially in elderly. Though oral anticoagulation (OAC) is an effective mode of prevention of stroke in patients of AF, bleeding complication remains a major concern. Because of these issues, a significant proportion of patients either does not receive or receive suboptimal doses of OAC.
Methods:
In such patients, percutaneous left atrial appendage (LAA) closure remains an interesting option. Experience and literature of this procedure from India have been sparse. We report the first single center experience, from India, of percutaneous LAA closure with Amplatzer Cardiac Plug in 10 patients of non-valvular AF. These patients had contraindications for OAC or had high risk of bleeding or labile international normalized ratio (INR) on therapy.
Results:
We successfully deployed the devices in all of the cases with no major complications perioperatively and on short-term follow-up. We also report a comprehensive review on the technique of percutaneous LAA closure using Amplatzer Cardiac Plug, including some novel modification with our experience of doing percutaneous mitral balloon valvuloplasty.
