title: [Percutaneous closure of left atrial appendage in non-valvular atrial fibrillation--international and Hungarian experiences].
abstract: In patients with non-valvular atrial fibrillation, efficacy of stroke prevention with oral anticoagulant therapy has been proved. Despite their high risk for thromboembolic events, there are substantial numbers of patients who are not candidates for long-term oral anticoagulant therapy, therefore the interest in alternative treatment strategies are in focus these days. The most common place within the heart for thrombus formation in patients with non-valvular atrial fibrillation is the left atrial appendage. Two devices specifically designed for percutaneous left atrial appendage closure are currently available in Europe: the WATCHMAN LAA system (Atritech, Inc) and the AMPLATZER Cardiac Plug (AGA Medical Corporation). Although present trial results (PLAATO, PROTECT AF) suggest that LAA closure may be performed at acceptable safety and it may reduce the long-term stroke risk, available data are still very limited. At present these procedures may be an acceptable alternative in selected high-risk patients with non-valvular atrial fibrillation who are not or suboptimal candidates for oral anticoagulant therapy. On 28. January, 2010 we performed the first three successful percutaneous left atrial appendage closure procedures in Gottsegen György Hungarian Institute of Cardiology in Hungary.
authors.affiliation: Gottsegen György Országos, Kardiológiai Intézet, Budapest. geza.fontos@kardio.hu
authors.forename: Géza
authors.initials: G
authors.lastname: Fontos
authors.forename: Péter
authors.initials: P
authors.lastname: Andréka
authors.forename: András
authors.initials: A
authors.lastname: Temesvári
authors.forename: Dóra
authors.initials: D
authors.lastname: Wéber
authors.forename: András
authors.initials: A
authors.lastname: Szatmári
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000497:Alloys; D000925:Anticoagulants / Q000008:administration & dosage; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D002986:Clinical Trials as Topic; D000075202:Contraindications; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D055989:Septal Occluder Device; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013906:Thoracoscopy; D013927:Thrombosis / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D000925:Anticoagulants; C013616:nitinol