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Updated: May 14, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Residual leaks after left atrial appendage occlusion
Claudio Sanfilippo1, Marco Frazzetto2, Matteo Pelliccia3
1Division of Cardiology, Centro Cuore Morgagni, Catania, Italy.
Summary
Peridevice leaks (PDL) after left atrial appendage occlusion (LAAO) are common. While small leaks may be clinically irrelevant, larger or evolving leaks may increase thromboembolic risk, requiring individualized management.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Peridevice leaks (PDL) are frequent after left atrial appendage occlusion (LAAO).
- Detection and clinical relevance of PDL vary based on anatomy, patient factors, device, and imaging.
- Transoesophageal echocardiography (TEE) is standard, but cardiac computed tomography angiography (CCTA) shows higher sensitivity for leaks.
Purpose of the Study:
- To review the detection, incidence, and clinical relevance of PDL after LAAO.
- To discuss the role of imaging modalities in PDL detection.
- To explore management strategies for significant PDL.
Main Methods:
- Literature review of studies on PDL after LAAO.
- Analysis of factors influencing PDL detection and outcomes.
- Discussion of current and emerging management strategies.
Main Results:
- Small PDL are often considered irrelevant, but recent data link them to increased thromboembolic risk.
- Leak size, location, and evolution over time impact clinical outcomes.
- Interventional closure is a viable strategy for significant PDL when anticoagulation is contraindicated.
Conclusions:
- Minimizing PDL requires careful device selection, pre-procedural planning, and optimal technique.
- Management of PDL is individualized due to limited randomized data.
- Further research is needed to define prognostic implications and standardize diagnostic/therapeutic algorithms.
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