TY - JOUR
T1 - Left Atrial Appendage Occlusion, A Misnomer?
T2 - Where Do We Go From Here?
AU - Holmes, David R.
AU - Simard, Trevor J.
AU - Killu, Ammar M.
AU - Alkhouli, Mohamad A.
N1 - Publisher Copyright:
© 2022 Mayo Foundation for Medical Education and Research
PY - 2022/8
Y1 - 2022/8
N2 - The importance of the left atrial appendage (LAA) as the source of thromboembolism including stroke in patients with nonvalvular atrial fibrillation is well documented, with more than 90% of ischemic strokes related to a LAA thrombus. Although oral anticoagulation has been the standard of care, approximately 50% to 60% of patients either have contraindications to oral anticoagulation or do not continue the medication beyond the first year. This led to the development of local site-specific therapy to occlude the LAA by either surgical or transcatheter means. Despite marked advancements, incomplete LAA closure with surgical and transcatheter approaches remains frequent. The etiology of incomplete LAA closure and its clinical implications remain unclear. Multiple strategies are in development including changes in deployment techniques, a new device design, and alternative approaches to leak closure.
AB - The importance of the left atrial appendage (LAA) as the source of thromboembolism including stroke in patients with nonvalvular atrial fibrillation is well documented, with more than 90% of ischemic strokes related to a LAA thrombus. Although oral anticoagulation has been the standard of care, approximately 50% to 60% of patients either have contraindications to oral anticoagulation or do not continue the medication beyond the first year. This led to the development of local site-specific therapy to occlude the LAA by either surgical or transcatheter means. Despite marked advancements, incomplete LAA closure with surgical and transcatheter approaches remains frequent. The etiology of incomplete LAA closure and its clinical implications remain unclear. Multiple strategies are in development including changes in deployment techniques, a new device design, and alternative approaches to leak closure.
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U2 - 10.1016/j.mayocp.2022.03.026
DO - 10.1016/j.mayocp.2022.03.026
M3 - Review article
C2 - 35933138
AN - SCOPUS:85135399453
SN - 0025-6196
VL - 97
SP - 1525
EP - 1533
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 8
ER -