Left atrial appendage closure devices. Their role in 2013

• Published in: Minerva cardioangiologica Vol. 61; no. 2; p. 125
• Main Authors: Mangner, N, Sandri, M, Lurz, P, Dähnert, I, Schuler, G, Möbius-Winkler, S
• Format: Journal Article
• Language: English
• Published: Italy 01-04-2013
• Subjects: Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Atrial Fibrillation - surgery; Clinical Trials as Topic; Combined Modality Therapy; Embolic Protection Devices - trends; Embolic Protection Devices - utilization; Fibrinolytic Agents - adverse effects; Fibrinolytic Agents - therapeutic use; Forecasting; Hemorrhage - chemically induced; Hemorrhage - prevention & control; Humans; Incidence; Prosthesis Design; Prosthesis Implantation - methods; Risk; Septal Occluder Device - trends; Septal Occluder Device - utilization; Severity of Illness Index; Stroke - epidemiology; Stroke - etiology; Stroke - prevention & control; Thromboembolism - epidemiology; Thromboembolism - etiology; Thromboembolism - prevention & control
• ISSN: 0026-4725

Stroke prevention is the major goal in treating patients with atrial fibrillation. Warfarin therapy, if used appropriately, is highly effective in preventing thromboembolic events, but is simultaneously burdened by a narrow therapeutic window, multiple food and drug interactions, and a substantial bleeding risk. New pharmacological agents show only a modest reduction of bleeding complications compared to warfarin. Percutaneous device left atrial appendage (LAA) closure has now been technologically advanced as an additional and potential alternative to pharmacotherapy in patients with AF. Promising randomized data are obtainable with the WATCHMAN® device, while several other devices are in various stages of clinical and preclinical development. In this article we review the current knowledge and status of this technique.