Percutaneous occlusion of the left atrial appendage for systemic embolism prevention in patients with atrial fibrillation: state of the art and report of two cases.
Atrial fibrillation is a benign arrhythmia but it is associated with an elevated thromboembolic risk. The treatment of choice is oral anticoagulation. However not all the patients can benefit from oral anticoagulation, due to bleeding risk or other contraindications. Considering that the most common embolic source in patients with atrial fibrillation is the left atrial appendage, different surgical techniques have been suggested for its closure. For patients at high risk, since August 2001 a device is available for percutaneous occlusion of the left atrial appendage (PLAATO). The PLAATO device consists of a self-expandable nitinol cage with small anchors on its surface to avoid systemic migration. The implantation procedure is performed with local anesthesia. It requires transseptal puncture and the device is delivered to the appendage through a specially designed sheath. The maneuver is performed under transesophageal and fluoroscopic guidance. At present more than 250 patients have been implanted, and the results, as far as the safety and the effectiveness are concerned, are really promising. We report 2 cases of recently successfully implanted at our Center.
Barbato
Gaetano
G
Maggiore Hospital, Bologna, Italy. Gaetano.Barbato@ausl.bologna.it
Carinci
Valeria
V
Pergolini
Francesco
F
Di Pasquale
Giuseppe
G
D000368:Aged; D000925:Anticoagulants; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications*; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D000075202:Contraindications; D006801:Humans; D008297:Male; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants