title: Left Atrial Appendage Ligation And Exclusion Technology In The Incubator.
abstract: Stroke is the most feared complication of atrial fibrillation (AF). Targeting the left atrial appendage (LAA) mechanically is attractive as a means to simultaneously reduce stroke risk, the need for anticoagulation, and hemorrhagic complications in patients with non-valvular AF. The results of the PROTECT-AF and PREVAIL randomized clinical trials support this approach as a viable therapeutic alternative to warfarin in selected patients and add to accumulating evidence regarding the importance of the LAA in thromboembolism in AF. A number of devices for percutaneous LAA closure are under investigation or development. In this article, key design features of these ligation and exclusion technologies will be discussed, with a focus on aspects of LAA morphology, relational anatomy, thrombosis, and thromboembolism relevant for successful device development and deployment.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Faisal F
authors.initials: FF
authors.lastname: Syed
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Amit
authors.initials: A
authors.lastname: Noheria
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christopher V
authors.initials: CV
authors.lastname: DeSimone
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
keywords: Anatomy; Device; Exclusion; Left Atrial Appendage; Ligation; Technology; Thromboembolism