Cardiovascular Therapies Targeting Left Atrial Appendage

Mohit K. Turagam, Poonam Velagapudi, Saibal Kar, David Holmes, Vivek Y. Reddy, Marwan M. Refaat, Luigi Di Biase, Amin Al-Ahmed, Mina K. Chung, Thorsten Lewalter, James Edgerton, James Cox, John Fisher, Andrea Natale, Dhanunjaya R. Lakkireddy

Research output: Contribution to journalReview article

7 Scopus citations

Abstract

Left atrial appendage (LAA) closure has evolved as an effective strategy for stroke prevention in patients with atrial fibrillation who are considered suitable for oral anticoagulation. There is strong evidence based on randomized clinical trials with 1 percutaneous device, as well as a large registry experience with several devices, regarding the safety and efficacy of this strategy. In addition, there is encouraging data regarding the effect of epicardial LAA closure on decreasing arrhythmia burden and improvements in systemic homeostasis by neurohormonal modulation. However, there are several unresolved issues regarding optimal patient selection, device selection, management of periprocedural complications including device-related thrombus, residual leaks, and pericarditis. In this review, we summarize the rationale, evidence, optimal patient selection, and common challenges encountered with mechanical LAA exclusion.

Original languageEnglish (US)
Pages (from-to)448-463
Number of pages16
JournalJournal of the American College of Cardiology
Volume72
Issue number4
DOIs
StatePublished - Jul 24 2018

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Keywords

  • anticoagulants
  • atrial fibrillation
  • cardiac surgical procedures
  • stroke
  • thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Turagam, M. K., Velagapudi, P., Kar, S., Holmes, D., Reddy, V. Y., Refaat, M. M., Di Biase, L., Al-Ahmed, A., Chung, M. K., Lewalter, T., Edgerton, J., Cox, J., Fisher, J., Natale, A., & Lakkireddy, D. R. (2018). Cardiovascular Therapies Targeting Left Atrial Appendage. Journal of the American College of Cardiology, 72(4), 448-463. https://doi.org/10.1016/j.jacc.2018.05.048