Percutaneous Left Atrial Appendage Closure With the AMPLATZER Cardiac Plug Device in Patients With Nonvalvular Atrial Fibrillation and Contraindications to Anticoagulation Therapy

Abstract

In patients with nonvalvular atrial fibrillation at high risk of cardioembolic events and absolute contraindications to anticoagulation, LAAC using the ACP device followed by dual-/single-antiplatelet therapy was associated with a low rate of embolic and bleeding events after a mean follow-up of 20 months. No cases of severe residual leak or device thrombosis were observed at the 6-month follow-up.

Latest Advances in Transseptal Structural Heart Interventions

“…34 The device was successfully implanted in 51 of 52 patients (98%). Device embolization was observed in 1 patient (1.9%).…”

First-in-human experience with the Cardia Ultraseal left atrial appendage closure device: The feasibility study

“…Nowadays, oral anticoagulation still remains the state-of-the-art therapy for patients with AF. Since the first percutaneous LAA occlusion (LAAO) in 2002 [1] many studies have shown the safety and efficacy of this therapy using different closure devices [2][3][4][5][6][7][8][9]. Percutaneous LAAO is a valuable therapeutic option for selected high-risk patients with AF and contraindications for oral anticoagulation therapy.…”

Left Atrial Appendage Occlusion in Non-Valvular Atrial Fibrillation in a Korean Multi-Center Registry

“…This may be related to the double disc structure of the ACP, which contributes to better sealing. 12 Significant leakage (≥5 mm), however, was not detected and the incidence of clinical events was similar for both devices. Interestingly, all major leakages (3-5 mm) developed in patients in whom no peridevice leakage was detected immediately after the procedure.…”

“…Several possible explanations include incomplete device endothelialization, anatomical remodeling of LAA ostium over time, use of an undersized device without periprocedural residual leak due to LAA contraction immediately after implantation, and low left ventricular ejection fraction, which might increase the LA dimensions. 12 In general, the presence of peridevice leakage (<5 mm) was not clinically relevant, indicating that anticoagulation can be discontinued at the discretion of physicians. Significant leakage (≥5 mm) and the progressive increase of ble procedure as an alternative to anticoagulation in patients at high risk for bleeding or contraindication to anticoagulation, or in whom anticoagulation failed to prevent stroke.…”