Stroke and systemic thromboembolism are the most feared complications of atrial fibrillation (AF). The main source of thrombus in AF is left atrial appendage (LAA). Oral anticoagulation (OAC) therapy is the most effective prophylactic approach to reduce thromboembolic risk. However, there is a large number of patients in whom OAC is ineffective or contraindicated. For those patients, percutaneous LAA ligation may be an alternative treatment.Percutaneous epicardial LAA suture ligation with LARIAT is one of the most widely used techniques for LAA closure. In the literature, there are no studies that assess the impact of LAA in long term follow-up.The dissertation presents the results of a prospective study evaluating the incidence of stroke, thromboembolic events and bleeding after LAA closure in AF patients with high CHADS2-score, CHA2DS2-VAS-score and HAS-BLED in 5,5 years follow-up.Study conducted of 57 patients in study group (LAA Group) and 31 patients in Control Group. 5.5 years follow-up observations showed that LAA closure reduces the risk of stroke and other thromboembolism events. In LAA Group no thromboembolic events were observed. In Control Group thromboembolic events were present in 10% of patients, including CVA in 6.6% of patients. In LAA Groupin patients who stopped OAC there was 6 times less bleeding than in patients who continued OAC.LARIAT device significantly ; reduces the risk of stroke and thromboembolism events. Moreover, results suggest that stopped oral anticoagulation after epicardial LAA closure does not increase the risk of stroke. LAA closure may be an alternative treatment in AF.
Mar 16, 2023
Aug 23, 2016
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http://dl.cm-uj.krakow.pl:8080/publication/4097
Edition name | Date |
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ZB-124960 | Mar 16, 2023 |
Litwinowicz, Radosław
Słodowska, Katarzyna
Burysz, Marian
Kiełbasa, Grzegorz Stanisław
Lenart-Migdalska, Aleksandra
Kocowska, Maryla
Myrdko, Tomasz