title: Percutaneous closure of the left atrial appendage to prevent ischaemic stroke in patients with atrial fibrillation who require but have contraindications to oral anticoagulation.
abstract: Atrial fibrillation (AF) is associated with a five-fold increased risk for stroke due to cardioembolic events. Most strokes in patients with AF arise from thrombus formation in the left atrial appendage (LAA). Oral anticoagulation is a standard treatment of AF patients with high risk of stroke. However, the main drawbacks of oral anticoagulation are high risk of major bleeding and imperfect effectiveness dependent on a very narrow therapeutic range. In this article, based on two case reports, we describe a method of percutaneous closure of the LAA. We discuss indications, describe the procedure and mention possible complications. LAA closure seems to be a promising tool to prevent AF-related strokes in a selected group of patients.
authors.affiliation: I Katedra i Klinika Kardiologii, Śląski Uniwersytet Medyczny, SPK7, Katowice. tbochun@poczta.onet.pl.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Węglarz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bochenek
authors.forename: Maciej
authors.initials: M
authors.lastname: Swiat
authors.forename: Ewa
authors.initials: E
authors.lastname: Konarska-Kuszewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wróbel
authors.forename: Bogusława
authors.initials: B
authors.lastname: Czyrnik
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Spisak-Borowska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opala
authors.forename: Maria
authors.initials: M
authors.lastname: Trusz-Gluza
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D002545:Brain Ischemia / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D000075202:Contraindications; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011474:Prosthesis Design; D020521:Stroke / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants