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Updated: Dec 31, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Light anti-thrombotic regimen for prevention of device thrombosis and/or thrombotic complications after interatrial
Gianluca Rigatelli1, Marco Zuin2, Fabio Dell'Avvocata1
1Section of Adult and Congenital Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, 45100, Rovigo Italy.
Insights
Six months of Aspirin (ASA) therapy after atrial septal defect (ASD) or patent foramen ovale (PFO) device closure is safe and effective. This regimen successfully prevented device thrombosis and major bleeding events in a large patient cohort.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- The optimal antiplatelet strategy following atrial septal defect (ASD) or patent foramen ovale (PFO) device closure is not well-established.
- Intracardiac echocardiography (ICE)-aided closure is a common method for interatrial shunts.
Purpose of the Study:
- To evaluate the safety and long-term effectiveness of a 6-month regimen of 100 mg Aspirin (ASA) after ICE-aided ASD/PFO device closure.
- To assess the incidence of bleeding events, shunt persistence, and device thrombosis.
Main Methods:
- A large, single-center retrospective analysis of 734 patients who underwent catheter-based interatrial shunt closure over 15 years.
- Patients received 100 mg ASA for 6 months post-procedure, with long-term follow-up (mean 10.3 years).
Main Results:
- No major bleeding events were observed; minor bleeding occurred in 0.9% of patients.
- Device thrombosis was 0% in the ASD group and 0.2% in the PFO group.
- A cerebral ischemic event occurred in 0.4% of the cohort, with 1.36% requiring lifelong ASA due to persistent shunts.
Conclusions:
- A 6-month course of 100 mg ASA is a safe and effective antiplatelet strategy after ASD/PFO device closure.
- This regimen effectively prevents device thrombosis and major bleeding complications.
- Long-term follow-up supports the safety and efficacy of this treatment protocol.
Aims:
The optimal antiplatelet therapy after atrial septal defect (ASD) or patent foramen ovale device closure (PFO) remain to be established. We evaluated the safety and effectiveness of 6-month 100 mg Aspirin (ASA) regimen in the very long-term follow up after intracardiac echocardiography (ICE) -aided interatrial shunt closure in a large retrospective cohort.
Methods:
Single-center retrospective analysis which included medical and instrumental data of 789 consecutive patients referred to our institution over a 15 years period due interatrial shunt catheter-based closure.
Results:
Finally, 734 patients were included in the analysis (mean age 46.1 ± 14.6 years, 398 females): ASD and PFO closure were successfully performed in 281 and 453 patients, respectively. Over the follow-up period, no major bleeding events were observed while the rate of minor bleeding events was 0.9%. Tolerance problems were detected in 3.4% of cases (n==28). In 11 patients (1.5%) an abnormal complete blood count was detected and monitored up to normalization. On a mean follow -up of 10.3 ± 3.0 years (range 1-15), 10 patients (1.36%) had a persistent moderate shunt 12 months after closure and maintained Aspirin 100 mg life-long, whereas the remaining 724 suspended the treatment after 6 months. Device thrombosis in ASD and PFO groups were 0% and 0.2%, respectively. A cerebral ischemic event occurred in 0.4% of the entire cohort.
Conclusions:
A regimen of 100 mg of ASA for six months after ASD/PFO closure appeared to be both safe and effective in preventing device thrombosis and major bleedings.
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