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Left Atrial Appendage Occlusion in Solid Organ Transplant Patients
Alden J Dunham1, Madison Noom1, Fahad Hawk2
1University of South Florida Morsani College of Medicine, Tampa, Florida, USA.
Insights
Left atrial appendage occlusion (LAAO) offers stroke prevention for atrial fibrillation patients. This study shows LAAO is safe and effective in solid organ transplant recipients, allowing anticoagulation cessation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Medical Devices
Background:
- Atrial fibrillation (AF) patients often require stroke prevention.
- Percutaneous left atrial appendage occlusion (LAAO) is an alternative to anticoagulation.
- Solid organ transplantation (SOT) recipients were excluded from initial LAAO trials.
Observation:
- This study evaluated LAAO in SOT recipients.
- Patient-level data on indication, safety, and outcomes were collected.
- All patients underwent successful LAAO device implantation.
Findings:
- The procedure demonstrated excellent efficacy and safety in SOT recipients.
- No major periprocedural complications were observed.
- Systemic anticoagulation was successfully discontinued post-procedure.
Implications:
- LAAO is a viable stroke prevention strategy for SOT patients with AF.
- This expands the use of LAAO to a previously understudied population.
- Further research can confirm long-term outcomes in this cohort.
Abstract:
Percutaneous left atrial appendage occlusion (LAAO) is increasingly used to provide nonpharmacologic stroke prevention in patients with atrial fibrillation, particularly patients at high risk for complications of anticoagulation. Randomized controlled trials establishing LAAO safety and efficacy excluded solid organ transplantation recipients; thus, the role of LAAO in these patients is poorly understood. We present a series of patients with a history of solid organ transplantation who underwent LAAO and include patient-level data on indication, safety, and long-term outcomes. Our cohort demonstrated excellent efficacy and procedural safety with successful implantation in all cases, no major periprocedural complications, and successful discontinuation of systemic anticoagulation.
