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Related Concept Videos

Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Related Experiment Video

Updated: Jul 12, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Early Nonprocedural Bleeding After Left Atrial Appendage Occlusion.

Jules Mesnier1, Ignacio Cruz-González2, Paul Guedeney3

  • 1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.

JACC. Cardiovascular Interventions
|July 18, 2024
PubMed
Summary

Early nonprocedural bleeding after left atrial appendage occlusion (LAAO) affects 7% of patients and increases mortality risk. Dual antiplatelet therapy at discharge is a key predictor, highlighting the need for careful antithrombotic strategy selection.

Keywords:
anticoagulantatrial fibrillationbleedingleft atrial appendage occlusion

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Thrombosis Research

Background:

  • Patients undergoing left atrial appendage occlusion (LAAO) face a high risk of bleeding.
  • Intensive antithrombotic therapy is crucial post-LAAO to prevent device-related thrombosis.

Purpose of the Study:

  • To determine the incidence, consequences, and predictors of early nonprocedural bleeding following LAAO.
  • To assess the impact of early bleeding on patient outcomes.

Main Methods:

  • Multicenter study involving 1,649 patients who underwent LAAO.
  • Early nonprocedural bleeding defined as events within 3 months post-implantation, assessed using Valve Academic Research Consortium-2 criteria.
  • Sensitivity analysis conducted at 45 days.

Main Results:

  • 121 patients (7.3%) experienced early nonprocedural bleeding, with 57% classified as major.
  • Predictors included dual antiplatelet therapy (DAPT) at discharge, prior gastrointestinal bleeding, and multiple prior bleeding sites.
  • Early nonprocedural bleeding independently predicted increased all-cause mortality (aHR: 1.53).

Conclusions:

  • Early nonprocedural bleeding occurs in approximately 7% of LAAO patients within 3 months, often major, and is linked to higher mortality.
  • DAPT at discharge significantly increases the risk of early nonprocedural bleeding.
  • These findings underscore the critical role of bleeding risk assessment in guiding antithrombotic strategies post-LAAO.