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Left Atrial Appendage Closure: A Current Overview Focused on Technical Aspects and Different Approaches
Fabrizio Guarracini1, Marta Martin1, Massimiliano Marini1, Stefano Branzoli2,3, Giulia Casagranda4, Daniele Muser5,6, Giovanni B. Forleo7, Alessio Gasperetti7,8, Massimo Di Marco9, Stefano Guarracini10, Roberto Bonmassari1, Patrizio Mazzone11, Antonio M Calafiore12, Michele Di Mauro10,13,*
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1
Department of Cardiology, Santa Chiara Hospital, 38122 Trento, Italy
2
Department of Cardiac Surgery, Santa Chiara Hospital, 38122 Trento, Italy
3
Department of Cardiac Surgery, UZ Brussel, 1090 Brussels, Belgium
4
Department of Diagnostic Imaging, APSS of Trento, 37122 Trento, Italy
5
Cardiac Electrophysiology, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
6
Cardiothoracic Department, Udine General Hospital, 33100 Udine, Italy
7
Cardiology Unit, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, 20157 Milan, Italy
8
Division of Cardiology, Department of Medicine, Johns Hopkins University, Johns Hopkins Hospital, Baltimore, MD 21287, USA
9
Department of Cardiology, “Santo Spirito" Hospital, 00193 Pescara, Italy
10
Department of Cardiology, “Pierangeli" Hospital, 00193 Pescara, Italy
11
Arrhythmology and Cardiac Pacing Unit, San Raffaele Hospital, 20132 Milan, Italy
12
Division of Cardiac Surgery A, Henry Dunant Hospital, 115 26 Athens, Greece
13
Cardio-Thoracic Surgery Unit, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), 6202 AZ Maastricht, The Netherlands
*Correspondence: mdimauro1973@gmail.com (Michele Di Mauro)
Academic Editor: Jinnette D. Abbott
Academic Editor: Jinnette D. Abbott
Rev. Cardiovasc. Med. 2022, 23(5), 155;
https://doi.org/10.31083/j.rcm2305155
Submitted: 23 December 2021 | Revised: 27 February 2022 | Accepted: 14 March 2022 | Published: 26 April 2022
(This article belongs to the Special Issue Structural Heart Interventions)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Several studies in literature have shown that 90% of emboli related to non-valvular atrial fibrillation originate from left atrial appendage. Percutaneous closure or surgical exclusion of left atrial appendage in patients with high bleeding and high cardioembolic risk is currently a well established procedure in literature, clinical practice and guidelines. Knowledge of different techniques of left atrial appendage closure is necessary to individualize the procedure according to the patient anatomy and pre-procedural imaging evaluations. In this review the authors will evaluate different left atrial appendage closure systems and the different pre and intra procedural imaging methods.
Keywords
left atrial appendage occlusion
atrial fibrillation
bleeding risk
surgical left atrial appendage exclusion
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