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JR López-Mínguez, J Eldoayen-Gragera, R González-Fernández, C Fernández-Vegas, ME Fuentes-Cañamero, V Millán-Nuñez, JM Nogales-Asensio, A Martínez-Naharro, S Sánchez-Giralt, M Doblado-Calatrava and A Merchán-Herrera
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 CHADS(2) score of 2.41 (1.53) and a CHA(2)DS(2)-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. Full English text available from:www.revespcardiol.org/en.
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Concepts
Cardiology, Heparin, Anticoagulant, Left atrial appendage, Warfarin, Heart, Stroke, Atrial fibrillation
MeSH headings
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