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Am J Cardiol. 2016 Jan 1;117(1):84-90. doi: 10.1016/j.amjcard.2015.10.024. Epub 2015 Oct 28.

Comparison of Efficacy and Safety of Left Atrial Appendage Occlusion in Patients Aged <75 to ≥ 75 Years.

Author information

1
Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, Spain. Electronic address: xavierfreixa@hotmail.com.
2
CardioVascular Center Frankfurt, Frankfurt, Germany; Heart & Vascular Institute, Swedish Medical Center, Seattle, Washington.
3
Department of Cardiology, Hospital Clinic of Barcelona, University of Barcelona, Spain.
4
Department of Cardiology, University Hospital of Salamanca, Salamanca, Spain.
5
Department of Cardiology, University Hospital of Bern, Bern, Switzerland.
6
Department of Cardiology, University Hospital of Bonn, Bonn, Germany.
7
Division of Cardiology, Fondazione Toscana Gabriele Monasterio, Massa, Italy.
8
Division of Cardiology, Ospedale Careggi di Firenze, Florence, Italy.
9
Division of Cardiology, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium.
10
Department of Cardiology, Charite Universitätsmedizin Berlin, Berlin, Germany.
11
Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.
12
CardioVascular Center Frankfurt, Frankfurt, Germany.
13
Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom.
14
Department of Cardiology, Department of Cardiology, Cardiology University Heart Center, Zurich, Switzerland.
15
Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium.
16
Division of Cardiology, Ospedale Luigi Sacco, Milan, Italy.
17
Department of Cardiology, Coimbra's Hospital Center, Coimbra, Portugal.
18
Montreal Heart Institute, Montreal, Canada.
19
Department of Cardiology, Universitätsmedizin Göttingen, Göttingen, Germany.
20
Department of Cardiology, Asklepios Hospital Hamburg, Hamburg, Germany.
21
Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.

Abstract

Left atrial appendage occlusion (LAAO) is emerging as a promising alternative to oral anticoagulation. Because aged patients present a greater risk of not only cardioembolic events but also major bleeding, LAAO might represent a valid alternative as this would allow oral anticoagulation cessation while keeping cardioembolic protection. The objective of the study was to explore the safety and efficacy of LAAO in elderly patients. Data from the AMPLATZER Cardiac Plug multicenter registry were analyzed. The cohort was categorized in 2 groups (<75 vs ≥ 75 years). A total of 1,053 subjects were included in the registry. Of them, 219 were excluded because of combined procedures. As a result, 828 subjects were included (54.6% ≥ 75 years). Procedural success was high and similar in both groups (97.3%). Acute procedural major adverse events were not statistically different among groups (3.2% in <75 years vs 5.1%; p = 0.17) although stratified analysis showed a higher incidence of cardiac tamponade in elderly patients (0.5% vs 2.2%; p = 0.04). With a median follow-up of 16.8 months, no significant differences in stroke/TIA (1.9% vs 2.3%; p = 0.89) and major bleeding (1.7% vs 2.6%; p = 0.54) were observed. In conclusion, LAAO was associated with similar procedural success in patients aged <75 and ≥ 75 years although older patients had a higher incidence of cardiac tamponade. At follow-up, stroke and major bleeding rates were similar among groups.

PMID:
26552507
DOI:
10.1016/j.amjcard.2015.10.024
[Indexed for MEDLINE]

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