title: Interventional closure of the left atrial appendage for stroke prevention.
abstract: BACKGROUND
  Transcatheter left atrial appendage (LAA) closure is an alternative therapy for stroke prevention in atrial fibrillation (AF) patients. However; real-world efficacy, safety and complications have yet to be investigated. We sought to determine the procedural outcomes and potential complications of LAA closure in routine clinical practice at a high-volume center.
  
  
  RESULTS
  The study group comprised 179 patients (105 males; 72.7±9.0 years) with AF undergoing LAA closure at a single center in Germany. The rate of successful implantation was 98.9% (2 patients did not undergo implantation) and the overall procedure-related complication rate was 11.2% (major: 3.3%: tamponade 2; possibility of transient ischemic attack (TIA) 1; device dislocation 3; minor: 7.8%: pericardial effusion 2; air embolization with transient ST segment elevation 3; thrombus on device/sheath 3; puncture complications 5). At 45 days; 99.4% showed successful sealing of the LAA and 94.5% discontinued oral anticoagulation (OAC). TIA occurred in 2 patients during 6-month follow-up; but no cases of stroke were reported. There were no hemorrhagic stroke or device-related deaths. Only 1 patient was hospitalized with traumatic subdural hematoma. Minor bleeding was reported in 5 patients.
  
  
  CONCLUSIONS
  Transcatheter LAA closure in a high-volume center is safe and feasible. Life-threatening complications are rare. Discontinuation of OAC 45 days after implantation was also safe.
authors.affiliation: Department of Cardiology, University Leipzig-Heart Center Leipzig.
authors.forename: Yae
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Marcus
authors.initials: M
authors.lastname: Sandri
authors.forename: Norman
authors.initials: N
authors.lastname: Mangner
authors.forename: Nicolas
authors.initials: N
authors.lastname: Majunke
authors.forename: Ingo
authors.initials: I
authors.lastname: Dähnert
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: Sven
authors.initials: S
authors.lastname: Möbius-Winkler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*