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Updated: Sep 13, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Combined Percutaneous Left Atrial Appendage Closure and Mitral Transcatheter Edge-to-Edge Repair: Current Evidence
Michele Galasso1,2, Michele Morosato3,4, Greta Cattaneo2,5
1School of Medicine and Surgery Milano-Bicocca University Milan Italy.
Insights
Combining percutaneous left atrial appendage closure and transcatheter mitral repair offers a comprehensive solution for patients with atrial fibrillation and severe mitral regurgitation, potentially avoiding lifelong anticoagulation and its risks.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Atrial fibrillation frequently coexists with severe mitral regurgitation.
- This combination necessitates long-term anticoagulation, increasing bleeding risks.
- Current management strategies pose significant challenges for high-risk patients.
Purpose of the Study:
- To review the combined approach of percutaneous left atrial appendage closure and mitral transcatheter edge-to-edge repair.
- To evaluate the benefits and risks of this combined intervention.
- To provide insights for optimizing patient management.
Main Methods:
- Systematic review of existing literature.
- Analysis of procedural outcomes and complications.
- Assessment of stroke risk mitigation and anticoagulation avoidance.
Main Results:
- The combined approach addresses both stroke risk (via LAA closure) and mitral regurgitation.
- It potentially eliminates the need for lifelong oral anticoagulants.
- This strategy may reduce the necessity for multiple procedures.
Conclusions:
- Combined percutaneous left atrial appendage closure and transcatheter mitral repair is a promising strategy for select patients.
- Further long-term follow-up is crucial to confirm improved prognosis.
- This approach could enhance management of high-risk patients with atrial fibrillation and mitral regurgitation.
Abstract:
Atrial fibrillation commonly coexists with severe mitral regurgitation, complicating management by necessitating long-term anticoagulation, with its associated bleeding risk. The combined approach of percutaneous left atrial appendage closure and mitral transcatheter edge-to-edge repair has been proposed as a comprehensive solution, mitigating stroke risk while addressing mitral regurgitation. This approach eliminates the need for a second procedure and lifelong oral anticoagulants. Our review provides insights into the benefits and risks of combined procedures, potentially aiding clinicians in optimizing management for these patients. Long-term follow-up will determine whether combining these interventions improves prognosis in high-risk patients with atrial fibrillation.
