Percutaneous Occlusion of the Left Atrial Appendage with Thrombus Irresponsive to Antithrombotic Therapy

Autor:	Paweł Ptaszyński, Zbigniew Kalarus, Rafal Plaksej, Krzysztof Kaczmarek, Iwona Cygankiewicz, Piotr Jakubowski, Jerzy Krzysztof Wranicz, Anna Babicz-Sadowska, Witold Streb, Marek Grygier, Agata Markiewicz
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	medicine.medical_specialty Percutaneous medicine.drug_class left atrial appendage lcsh:Medicine 030204 cardiovascular system & hematology Article mechanical valve percutaneous closure 03 medical and health sciences 0302 clinical medicine Left atrial Antithrombotic Occlusion medicine In patient 030212 general & internal medicine cardiovascular diseases Thrombus Appendage business.industry Anticoagulant lcsh:R anticoagulant General Medicine closure medicine.disease Surgery thrombus business
Zdroj:	Journal of Clinical Medicine Volume 10 Issue 4 Journal of Clinical Medicine, Vol 10, Iss 726, p 726 (2021)
ISSN:	2077-0383
Popis:	We analyzed clinical experience with percutaneous closure of instances of left atrial appendage with thrombus (LAAT) irresponsive to antithrombotic therapy in patients treated in three high-volume cardiology centers. Clinical and procedural data regarding consecutive patients who underwent percutaneous left atrial appendage closure (PLAAC) due to LAAT were retrospectively analyzed. The study population consisted of 17 patients (11 men 68 ± 14 years CHA2DS2VASC 4.7 ± 1.9 HASBLED 3 (0–5)) with LAAT confirmed by transesophageal echocardiography, and included 5 patients with mechanical heart valves. Most of the patients (94.1%) received anticoagulation therapy before PLAAC. All LAATs were located in distal portions of the appendage and occupied less than 30% of its volume. Occluding-device implantation was successful in 17 patients in one, a residual leak was disclosed. Appropriate positioning of occluders required more than 1 attempt in 6 individuals (35.3%) in 3 others (17.6%), the subjects’ devices had contact with thrombi. No procedural complications were noted. Midterm follow-up (median: 10 months) revealed no procedure-related complications or clinically diagnosed thromboembolism. Transesophageal echocardiography (TEE) performed after six months revealed device-related thrombus in one patient. We concluded that LAAT irresponsive to antithrombotic therapy might be effectively treated with PLAAC, even in patients with mechanical-valve prostheses.
Databáze:	OpenAIRE
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