title: Catheter-based left atrial appendage occlusion procedure: role of echocardiography.
abstract: Atrial fibrillation is a common, clinically significant arrhythmic disorder that results in increased risk of morbidity and mortality in affected patients. Atrial fibrillation is more prevalent among men compared with women and the risk for developing atrial fibrillation increases with advancing age. Ischaemic stroke is the most common clinical manifestation of embolic events from atrial fibrillation. While anticoagulation treatment is the preferred treatment, unfortunately, many patients have contraindications for anticoagulation treatment making this option unavailable to them. Previous data have shown that most thrombi that form in association with non-valvular atrial fibrillation occur in the left atrial appendage (LAA). It has been suggested that isolating the LAA from the body of the left atrium might reduce the risk of embolic events and that LAA obliteration may be a treatment option for patients with atrial fibrillation who are not candidates for anticoagulation treatment. Several procedures have been developed for isolation of the LAA, including surgical procedures as well as catheter-based ones. In this paper, we will review the currently available techniques, emphasizing the catheter-based ones. We will examine the increasing role of real-time three-dimensional transoesophageal echocardiography for appropriate screening and patient selection for these procedures, intra-procedural guidance, and follow-up care.
authors: NYU School of Medicine, New York, NY, USA. gila.perk@gmail.com
authors: Gila
authors: G
authors: Perk
authors: Simon
authors: S
authors: Biner
authors: Itzhak
authors: I
authors: Kronzon
authors: Muhamed
authors: M
authors: Saric
authors: Larry
authors: L
authors: Chinitz
authors: Keith
authors: K
authors: Thompson
authors: Takahiro
authors: T
authors: Shiota
authors: Asma
authors: A
authors: Hussani
authors: Roberto
authors: R
authors: Lang
authors: Robert
authors: R
authors: Siegel
authors: Saibal
authors: S
authors: Kar
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D020517:Atrial Appendage / Q000000981:diagnostic imaging*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening; D018579:Patient Selection; D011138:Polytetrafluoroethylene; D015995:Prevalence; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D011138:Polytetrafluoroethylene