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Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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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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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Recurring Bleeding Events Requiring Red Blood Cell Transfusion After Left Atrial Appendage Closure Are Associated

Manuella Bogdan1, Balázs Polgár1, Előd János Zsigmond1

  • 1Department of Cardiology, Central Hospital of Northern Pest-Military Hospital, 1134 Budapest, Hungary.

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|April 14, 2026
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Summary

Left atrial appendage closure (LAAC) effectively prevents stroke in atrial fibrillation patients, reducing bleeding events. Persistent bleeding post-procedure impacts long-term outcomes, requiring tailored management.

Keywords:
atrial fibrillationbleeding riskleft atrial appendage closureoral anticoagulation contraindicationstroke preventionwatchman device

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Left atrial appendage closure (LAAC) offers an alternative to oral anticoagulation for stroke prevention in nonvalvular atrial fibrillation (NVAF).
  • It is indicated for patients at high risk of thromboembolic events or bleeding complications.
  • The Watchman™ device is a commonly used implant for LAAC.

Purpose of the Study:

  • To evaluate the safety and efficacy of LAAC using the Watchman™ device.
  • To assess acute procedural outcomes, long-term thromboembolic and bleeding events, and mortality.
  • To identify predictors of adverse outcomes, including transfusion requirements.

Main Methods:

  • Single-center retrospective study of 70 consecutive patients undergoing successful LAAC.
  • Analysis of procedural success, complications, thromboembolic events, bleeding events, and mortality.
  • Mean follow-up duration of 1210 days.

Main Results:

  • High procedural success rate (98.6%) with low periprocedural complications.
  • Significant reduction in bleeding events (144 vs. 56 events) post-LAAC.
  • Overall mortality was 40%, with heart failure and infections as leading causes; transfusion requirements independently associated with increased mortality (HR=5.97).

Conclusions:

  • LAAC is a safe and effective alternative to long-term anticoagulation for NVAF patients.
  • LAAC significantly reduces bleeding burden without increasing thromboembolic mortality.
  • Persistent postprocedural bleeding is a major determinant of long-term prognosis, necessitating individualized, multidisciplinary management.