Clinical outcome and intraprocedural characteristics of left atrial appendage occlusion: a comparison between single-occlusive plug-type and dual-occlusive disc-type devices

被引：0

作者：

Primessnig, Uwe ^{[1
,2
,3
,4
,5
]}

Schrader, Helene ^{[1
,2
,3
,4
]}

Wiedenhofer, Julia M. ^{[1
,2
,3
,4
,5
]}

Trippel, Tobias D. ^{[1
,2
,3
,4
,5
]}

Parwani, Abdul S. ^{[1
,2
,3
,4
,5
]}

Blaschke, Florian ^{[1
,2
,3
,4
,5
]}

Hindricks, Gerhard ^{[2
,3
,4
,5
,6
]}

Falk, Volkmar ^{[2
,3
,4
,5
,7
]}

Dreger, Henryk ^{[1
,2
,3
,4
,5
]}

Sherif, Mohammad ^{[1
,2
,3
,4
]}

Boldt, Leif-Hendrik ^{[1
,2
,3
,4
,5
]}

机构：

[1] Campus Virchow Klinikum, Deutsch Herzzentrum Charite, Dept Cardiol Angiol & Intens Care Med, Berlin, Germany

[2] Free Univ Berlin, Berlin, Germany

[3] Humboldt Univ, Berlin, Germany

[4] Charite Univ Med Berlin, Berlin, Germany

[5] DZHK German Ctr Cardiovasc Res, Berlin, Germany

[6] Campus Charite Mitte, Dept Cardiol Angiol & Intens Care Med, Deutsch Herzzentrum Charite, Berlin, Germany

[7] Deutsch Herzzentrum Charite, Dept Cardiothorac & Vasc Surg, Berlin, Germany

来源：

FRONTIERS IN CARDIOVASCULAR MEDICINE | 2024年 / 11卷

关键词：

left atrial appendage occlusion (LAAO); atrial fibrillation (AF); oral anticoagulation (OAC); thromboembolic prevention; transient ischemia attack (TIA); single-occlusive plug type (SOPT); dual-occlusive disc type (DODT); ORAL ANTICOAGULATION; WATCHMAN DEVICE; STROKE PROPHYLAXIS; FOLLOW-UP; CLOSURE; FIBRILLATION; CONTRAINDICATION; ASAP;

D O I：

10.3389/fcvm.2024.1401974

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Percutaneous interventional left atrial appendage occlusion (LAAO) is a reliable, safe, and effective alternative for stroke prevention in selected patients with atrial fibrillation (AF). Methods: In a retrospective observational study, 149 patients underwent LAAO between 2016 and 2022 at the Department of Cardiology of the Charit & eacute;-Universit & auml;tsmedizin Berlin, Campus Virchow, with AF for prevention of thromboembolic complications. We compared patient characteristics, intraoperative details and postoperative outcomes between single-occlusive plug-type (SOPT) and dual-occlusive disc-type (DODT) devices. Results: In all patients, the device implantation was successful. 60 patients received a SOPT occluder, including Watchman (35%) and Watchman FLX Occluders (65%), while 89 patients received a DODT occluder, including Amplatzer Cardiac Plug (37.1%), the Amplatzer Amulet (25.8%), and the LAmbre occluder (37.1%) systems. Procedure duration was significantly longer for DODT occluder implantation (49 +/- 33 vs. 41 +/- 25 min, p = 0.018). There were no in-hospital deaths or thromboembolic events reported after LAAO in both groups. Beyond that, a low rate of bleeding or access-side-related complications and pericardial tamponades were observed. Anticoagulation at discharge varied. About 60.8% of patients received dual antiplatelet therapy at hospital discharge, and 33.1% received direct oral anticoagulants. A 6-month follow-up was obtained in 85% of the patients. All implanted devices were in the desired position. However, in 5.7% of the patients, a device-related thrombus formation was detected in the SOPT group, while no thrombus was seen in the DODT group (p = 0.11). Thromboembolic events were noticed in 3.1%, without any difference between the device types. There was a statistically non-significant trend for less residual device leaks after SOPT vs. DODT implantation (no leak in 71.7% vs. 62.2%, p = 0.07; minor leaks <5 mm, 9.4% vs. 20.3%, p = 0.1). In the SOPT group, less bleeding complications were reported after LAAO (11.3% vs. 17.6%, p = 0.1). Conclusion: Our data suggest the safety and efficiency of LAAO with a very high procedural implantation success rate irrespective of the used LAA device. Furthermore, no relevant procedural or device-related complication occurred during the 6-month follow-up in all patients.

引用

页数：7