Anesthetic Management of Patients Undergoing Percutaneous Endocardial and Epicardial Left Atrial Appendage Occlusion

Area of Science:

• Cardiology
• Medical Devices
• Interventional Procedures

Background:

• Atrial fibrillation (AF) is a prevalent cardiac arrhythmia in adults.
• Heart failure and thromboembolic events are common comorbidities in AF patients.
• Chronic anticoagulation is standard but carries risks and limitations.

Purpose of the Study:

• To review percutaneous left atrial appendage occlusion (LAAO) devices as an alternative to anticoagulation in AF.
• To detail the procedures and anesthetic considerations for LAAO devices.
• To discuss the management of adverse events associated with LAAO.

Main Methods:

• Review of percutaneous LAAO device procedures.
• Description of anesthetic management for LAAO.
• Analysis of adverse event management strategies.

Main Results:

• Several LAAO devices, including WATCHMAN and LARIAT, have been developed.
• Some devices demonstrate non-inferiority to anticoagulation in preventing strokes.
• Detailed procedural and anesthetic information is provided.

Conclusions:

• LAAO devices represent a significant innovation for stroke risk reduction in AF.
• These devices offer a viable alternative to chronic anticoagulation for select patients.
• Understanding procedural nuances and adverse event management is crucial for successful LAAO implementation.