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Rev Esp Cardiol (Engl Ed). 2013 Feb;66(2):90-7. doi: 10.1016/j.rec.2012.04.017. Epub 2012 Aug 29.

Immediate and one-year results in 35 consecutive patients after closure of left atrial appendage with the Amplatzer cardiac plug.

Author information

1
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain. Electronic address: lopez-minguez@hotmail.com.
2
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.

Abstract

INTRODUCTION AND OBJECTIVES:

Left atrial appendage closure can be an attractive option for patients with nonvalvular atrial fibrillation and a contraindication to oral anticoagulants, provided that satisfactory results can be achieved during implantation and follow-up.

METHODS:

Thirty-five consecutive patients, not eligible for randomized trials with oral anticoagulants, had an Amplatzer occlusion device implanted under general anesthesia. After the first 5 patients, 3-dimensional imaging was incorporated. The results of the implantation and the follow-up were analyzed over a 1-year period.

RESULTS:

The mean age was 74.65 (7.61) years, with a CHADS2 score of 2.41 (1.53) and a CHA2DS2-VASc score of 3.17 (1.60). Implantation failed in 1 patient and 5 needed a change in the selected plug size. There were no cardiac complications during the implantation or hospital stay. There was 1 vascular complication (arteriovenous fistula). Transesophageal echocardiography monitoring was performed at 24h, 1, 3, 6, and 12 months and we found 5 thrombi which were resolved with heparin. In the follow-up period of 21.14 (10.09) months, 3 patients aged>80 years died, none of them due to heart problems, and one transient ischemic stroke without further consequences.

CONCLUSIONS:

Left atrial appendage closure by an experienced operator can be a treatment option with few complications and with efficient results at>1 year in reducing thromboembolic and hemorrhagic complications, even in very high-risk groups.

PMID:
24775381
DOI:
10.1016/j.rec.2012.04.017
[Indexed for MEDLINE]

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