Percutaneous closure of left atrial appendage to prevent thomboembolism in atrial fibrillation

Fernando Cura, Mariano Albertal, Gerardo Nau, Sebastián Peralta, Ricardo Ronderos, Gustavo Avegliano, Gustavo Sánchez, Jorge Belardi

Abstract


Embolic stroke is a major concern in atrial fibrillation (AF), and anticoagulation is the therapy of choice to prevent it. Around 20% of patients with AF have contraindications for anticoagulation (OAC). The left atrial appendage (LAA) has been identified as the most common place of thrombosis in patients with AF, particularly in those with non-valvular AF or impaired ventricular function. LAA occlusion reduces the incidence of embolic events in these patients. This article describes a case of percutaneous closure of LAA with the Amplatzer Cardiac Plug device. The patient was at high risk of embolism and had absolute contraindication for OAC. The procedure was performed at the cardiac catheterization laboratory under general anesthesia with fluoroscopic guidance and transesophageal echocardiography, and complete closure of the LAA was achieved. During the procedure, no complications were reported. The patient remained event-free at three-month follow-up, with complete exclusion of LAA. No embolic events have been reported.


References


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar