Cardiology Letters 2020, 29(5):310-379

Left atrial appendage occlusion, early and late complications

Mišíková S^{1, 2}, Juhás S^{1, 2}, Ondušová D¹, Šimurda M^{1, 2}

¹ Východoslovenský ústav srdcových a cievnych chorôb, a. s., Arytmologické oddelenie I. Klinika kardiológie, Košice

² Lekárská fakulta UPJŠ, Košice, Slovenská republika

Objective: The aim of the observational, retrospective and single-centre study is to analyse early and late complications due to left atrial appendage occlusion with Amplatzer AmuletTM.

Methods: We analyzed 49 patients (21 female and 28 male) with mean age of 72.1 ± 7.4 years. All patients were diagnosed with non-valvular atrial fibrillation and with high risk of thromboembolic (CHA2DS2-VASc 4,1 ± 1.3) and bleeding (HASBLED 3.3 ± 0.9) complications. We observed periprocedure, early (within 7 days after the procedure) and late complications: vascular, bleeding, stroke, systemic embolization, device embolization, pericardiac effusion and death.

Results: The left atrial appendage was successfully managed in 47 (94.9%) patients. We observed one periprocedural complication - thrombus on the sheath. During follow-up 18.2 ± 17.7 month we observed one intracranial bleeding, one chronic pericardial effusion and 8 deaths. There was no connection between procedure and death in 5 patients, in 3 patients we were unable to determine the cause of death.

Conclusion: Left atrial appendage occlusion is an effective and safe alternative to anticoagulation therapy in patients with nonvalvular atrial fibrillation and contraindication of anticoagulation therapy. The risk of complication is low thanks to correct selection of patients, strict compliance with the deployment rules and careful monitoring of patients. Fig. 3, Tab. 6.

Keywords: atrial fibrillation; stroke; left atrial appendage occlusion; Amplatzer Cardiac Plug, Amulet

Published: May 1, 2020  Show citation