Immediate and one-year results in 35 consecutive patients after closure of left atrial appendage with the Amplatzer cardiac plug.
OBJECTIVE
Left atrial appendage closure can be an attractive option for patients with nonvalvular atrial fibrillation and a contraindication to oral anticoagulants, provided that satisfactory results can be achieved during implantation and follow-up.


METHODS
Thirty-five consecutive patients, not eligible for randomized trials with oral anticoagulants, had an Amplatzer occlusion device implanted under general anesthesia. After the first 5 patients, 3-dimensional imaging was incorporated. The results of the implantation and the follow-up were analyzed over a 1-year period.


RESULTS
The mean age was 74.65 (7.61) years, with a CHADS2 score of 2.41 (1.53) and a CHA2DS2-VASc score of 3.17 (1.60). Implantation failed in 1 patient and 5 needed a change in the selected plug size. There were no cardiac complications during the implantation or hospital stay. There was 1 vascular complication (arteriovenous fistula). Transesophageal echocardiography monitoring was performed at 24h, 1, 3, 6, and 12 months and we found 5 thrombi which were resolved with heparin. In the follow-up period of 21.14 (10.09) months, 3 patients aged>80 years died, none of them due to heart problems, and one transient ischemic stroke without further consequences.


CONCLUSIONS
Left atrial appendage closure by an experienced operator can be a treatment option with few complications and with efficient results at>1 year in reducing thromboembolic and hemorrhagic complications, even in very high-risk groups.
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain. Electronic address: lopez-minguez@hotmail.com.
José R
JR
López-Mínguez
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Javier
J
Eldoayen-Gragera
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Reyes
R
González-Fernández
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Concepción
C
Fernández-Vegas
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
María E
ME
Fuentes-Cañamero
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Victoria
V
Millán-Nuñez
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Juan M
JM
Nogales-Asensio
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Ana
A
Martínez-Naharro
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Sara
S
Sánchez-Giralt
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Manuel
M
Doblado-Calatrava
Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Infanta Cristina de Badajoz, Badajoz, Spain.
Antonio
A
Merchán-Herrera
D000368:Aged; D020517:Atrial Appendage / Q000601:surgery*; D001281:Atrial Fibrillation / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055989:Septal Occluder Device; D013997:Time Factors