title: Percutaneous left atrial appendage occlusion - treatment outcomes and 6 months of follow-up - a single-center experience.
abstract: OBJECTIVE
  To present the results of treatment and evaluate 6 months of follow-up in a group of patients with non-valvular atrial fibrillation, who underwent the procedure of percutaneous left atrial appendage occlusion (PLAAO).
  
  
  METHODS
  Percutaneous left atrial appendage occlusion was performed in 34 patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation therapy. The risk of thromboembolic and bleeding complications was determined based on the CHA2DS2VASc and HAS-BLED scales. The Amplatzer Amulet system from St. Jude Medical was used. On the first postoperative day, all patients were started on double antiplatelet therapy with 75 mg/day of acetylsalicylic acid (ASA) and 75 mg/day of clopidogrel (CLO). On the 30(th) postoperative day, the efficacy of the antiplatelet therapy was assessed with impedance aggregometry using a Multiplate analyzer (Roche). Echocardiographic examinations were performed intraoperatively and on the first postoperative day; subsequently, follow-up examinations were conducted 1 and 6 months after the implantation.
  
  
  RESULTS
  In all patients, proper occluder position was observed throughout the follow-up. No leakage or thrombi around the implants were found. No strokes or bleeding complications associated with the antiplatelet therapy were observed. Multiplate assessment of platelet activity was conducted in 20 out of 34 patients. The efficacy of ASA treatment was demonstrated in all patients; no response to clopidogrel treatment was observed in 5 out of 20 patients. One patient suffered from cardiac tamponade, which required the performance of full sternotomy. Local complications (hematomas of the inguinal region) were observed in 3 patients. One of the patients died for reasons unrelated to the procedure.
  
  
  CONCLUSIONS
  Percutaneous left atrial appendage occlusion is an effective procedure in patients with non-valvular atrial fibrillation and contraindications for chronic anticoagulation therapy. Further observation is necessary to evaluate the longterm results.
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Michał
authors: M
authors: Karczewski
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Sebastian
authors: S
authors: Woźniak
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Radomir
authors: R
authors: Skowronek
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Marian
authors: M
authors: Burysz
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Marcin
authors: M
authors: Fischer
authors: Clinic of Cardiac Surgery, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland.
authors: Lech
authors: L
authors: Anisimowicz
authors: Clinic of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
authors: Marcin
authors: M
authors: Demkow
authors: Clinic of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
authors: Marek
authors: M
authors: Konka
authors: Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland.
authors: Wojciech
authors: W
authors: Ogorzeja
keywords: non-valvular atrial fibrillation; percutaneous left atrial appendage occlusion