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Left Atrial Appendage Occlusion in Patients With Thrombus in Left Atrial Appendage

Levent Sahiner, Cem Coteli1, Ergun Baris Kaya

  • 1Ankara City Hospital, Cardiology, Üniversiteler Mahallesi Bilkent Cad. No:1 Çankaya/ANKARA, Ankara, Çankaya 06800, Turkey. cemcoteli@hacettepe.edu.tr.

The Journal of Invasive Cardiology
|April 25, 2020
PubMed

Insights

Left atrial appendage (LAA) occlusion is a safe and effective treatment for patients with atrial fibrillation (AF) and LAA thrombus. This procedure offers an alternative for those who cannot use oral anticoagulation, demonstrating no major adverse events during follow-up.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Left atrial appendage (LAA) occlusion is an alternative for thromboembolic prevention in atrial fibrillation (AF) patients unsuitable for oral anticoagulation (OAC).
  • Traditionally, LAA thrombus was a contraindication for LAA occlusion, but recent evidence suggests it may be an indication in cases of resistant thrombus formation.
  • This study investigates the safety and efficacy of LAA occlusion in patients with pre-existing LAA thrombus.

Purpose of the Study:

  • To evaluate the safety and efficacy of percutaneous LAA occlusion in patients with LAA thrombus.
  • To assess the outcomes of LAA occlusion using the Amplatzer Amulet device in this specific patient population.

Main Methods:

  • A single-center study enrolled 12 non-valvular AF patients with LAA thrombus.
  • Patients underwent successful LAA occlusion with the Amplatzer Amulet device.
  • Follow-up included transesophageal echocardiography (TEE) at 1 and 6 months, with a median follow-up of 12 months.

Main Results:

  • All 12 patients underwent successful LAA occlusion without significant periprocedural adverse events.
  • No cardiovascular or all-cause mortality, ischemic cerebrovascular events, heart failure worsening, or major bleeding occurred during follow-up.
  • Transesophageal echocardiography revealed no device-related thrombus formation.

Conclusions:

  • Percutaneous LAA closure is a viable therapeutic option for patients with resistant LAA thrombus.
  • LAA occlusion demonstrates safety and efficacy in AF patients with LAA thrombus, even in the presence of high thromboembolic risk scores.
Abstract

Keywords:
LAALAA thrombusatrial fibrillationleft atrial appendagepercutaneous left atrial appendage closure

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