title: Left atrial appendage occlusion: single center experience with PLAATO LAA Occlusion System(®) and AMPLATZER™ Cardiac Plug.
abstract: OBJECTIVE
  To evaluate patient selection, safety, feasibility, and midterm results of percutaneous left atrial appendage (LAA) occlusion.
  
  
  BACKGROUND
  Oral anticoagulants (OAC) are the gold standard for stroke prevention in most patients with atrial fibrillation (AF). As the LAA is the main source of AF-related thrombi, LAA occlusion might reduce the thromboembolic (TE) risk. Recently, LAA closure was implemented in the European Society of Cardiology guidelines for the management of AF.
  
  
  METHODS
  This retrospective single center study examined all LAA percutaneous closures (September 2003-September 2011).
  
  
  RESULTS
  Twenty-five patients were included in the study; median age at closure was 73 years (minimum maximum range 49-85 years), 68% men. Median CHA2DS2-VASc score and HAS-BLED score were 5 (IQR 4-6) and 4 (IQR 4-5), respectively. Most frequent reason for LAA closure was intracranial hemorrhage during OAC treatment (52%). Successful device implantation was achieved in 96%. During a follow-up of 60.6 patient years, the TE stroke event rate was 4.95 per 100 patient years, versus an expected rate of 8.78 and 2.90 without and with OAC, respectively. No peripheral embolism occurred. Major procedure-related adverse events occurred in two patients.
  
  
  CONCLUSIONS
  Percutaneous closure of the LAA is feasible and safe. Intracranial hemorrhage was the most important indication for LAA closure. A low number of TE stroke events occurred during follow-up. LAA closure might be a good alternative in patients with a firm contraindication for OAC.
authors.affiliation: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. frederik.helsen@uzleuven.be
authors.forename: Frederik
authors.initials: F
authors.lastname: Helsen
authors.forename: Dieter
authors.initials: D
authors.lastname: Nuyens
authors.forename: Pieter
authors.initials: P
authors.lastname: De Meester
authors.forename: Filip
authors.initials: F
authors.lastname: Rega
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome
keywords: Atrial fibrillation; Implants; Interventional cardiology; Left atrial appendage closure; Thromboembolism