Left atrial appendage closure with Amplatzer cardiac plug in atrial fibrillation: initial European experience.
BACKGROUND
In most patients with atrial fibrillation (AF) and stroke, there is thrombotic embolization from the left atrial appendage (LAA). Percutaneous closure of the LAA is a novel alternative for the treatment of patients with AF at a high risk of stroke, in whom long-term anticoagulation therapy is not possible or not desired. This study details the initial experience with the Amplatzer Cardiac Plug (ACP) in humans.


METHODS
Investigator-initiated retrospective preregistry data collection to evaluate procedural feasibility and safety up to 24 hr after implantation of the ACP, a nitinol device designed for percutaneous trans-septal implantation in LAA of patients with paroxysmal, permanent, or persistent AF.


RESULTS
In 137 of 143 patients, LAA occlusion was attempted, and successfully performed in 132 (96%). There were serious complications in 10 (7.0%) patients (three patients with ischemic stroke; two patients experienced device embolization, both percutaneously recaptured; and five patients with clinically significant pericardial effusions). Minor complications were insignificant pericardial effusions in four, transient myocardial ischemia in two, and loss of the implant in the venous system in one patient.


CONCLUSIONS
The implantation of the ACP device is a feasible method for percutaneous occlusion of the LAA.
Park
Jai-Wun
JW
Department of Cardiology, Asklepios Klinik Harburg, Hamburg, Germany. j.park@asklepios.com
Bethencourt
Armando
A
Sievert
Horst
H
Santoro
Gennaro
G
Meier
Bernhard
B
Walsh
Kevin
K
Lopez-Minguez
Jose Ramon
JR
Lopez-Minquez
Jose Ramon
JR
Meerkin
David
D
Valdés
Mariano
M
Ormerod
Oliver
O
Leithäuser
Boris
B
D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D055989:Septal Occluder Device; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
D000497:Alloys; D000925:Anticoagulants; C013616:nitinol