Left Atrial Appendage Occlusion in High Bleeding Risk Patients
Objectives. The aim of this study was to investigate the outcomes of left atrial appendage occlusion (LAAO) in high bleeding risk patients suffering atrial fibrillation (AF) and to analyze the different antithrombotic therapies following the intervention. Background. Methods. This monocentric study...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/6704031 |
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| author | Pierluigi Merella Giovanni Lorenzoni Alessandro P. Delitala Filomena Sechi Federica Decandia Graziana Viola Paola Berne Gianluca Deiana Patrizio Mazzone Gavino Casu |
| author_facet | Pierluigi Merella Giovanni Lorenzoni Alessandro P. Delitala Filomena Sechi Federica Decandia Graziana Viola Paola Berne Gianluca Deiana Patrizio Mazzone Gavino Casu |
| author_sort | Pierluigi Merella |
| collection | DOAJ |
| description | Objectives. The aim of this study was to investigate the outcomes of left atrial appendage occlusion (LAAO) in high bleeding risk patients suffering atrial fibrillation (AF) and to analyze the different antithrombotic therapies following the intervention. Background. Methods. This monocentric study included 68 patients with nonvalvular AF with an absolute contraindication to OAT or at high bleeding risk. Follow-up was done with a clinical visit at 3-6-12 months. Results. Successful LAAO was achieved in 67/68 patients. At discharge, 32/68 patients were on dual antiplatelet therapy (APT), 34/68 were without any antithrombotic therapy or with a single antiplatelet drug, and 2/68 were on anticoagulant therapy. At three-month follow-up visit, 73.6% of the patients did not receive dual APT, of whom 14.7% had no thrombotic therapy and 58.9% were on single antiplatelet therapy. During a follow-up of 1.4 ± 0.9 years, 3/62 patients had late adverse effects (2 device-related thrombus without clinical consequences and 1 extracranial bleeding). The device-related thrombosis was not related to the antithrombotic therapy. Conclusions. LAAO is feasible and safe and prevents stroke in patients with AF with contraindication to oral anticoagulant therapy. After LAAO, single antiplatelet therapy seems to be a safe alternative to dual antiplatelet therapy, especially in patients at high bleeding risk. No benefit has been observed with dual APT. |
| format | Article |
| id | doaj-art-ce90f84a49e24a06b4870b122989c3ef |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-ce90f84a49e24a06b4870b122989c3ef2025-02-03T01:11:03ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/67040316704031Left Atrial Appendage Occlusion in High Bleeding Risk PatientsPierluigi Merella0Giovanni Lorenzoni1Alessandro P. Delitala2Filomena Sechi3Federica Decandia4Graziana Viola5Paola Berne6Gianluca Deiana7Patrizio Mazzone8Gavino Casu9Department of Cardiology, Ospedale San Francesco, Nuoro, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyIstituto di Clinica Medica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyNeurology Department and Stroke Unit, Ospedale San Francesco, Nuoro, ItalyArrhythmology and Cardiac Pacing Unit, Cardiothoracic and Vascular Department, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Cardiology, Ospedale San Francesco, Nuoro, ItalyObjectives. The aim of this study was to investigate the outcomes of left atrial appendage occlusion (LAAO) in high bleeding risk patients suffering atrial fibrillation (AF) and to analyze the different antithrombotic therapies following the intervention. Background. Methods. This monocentric study included 68 patients with nonvalvular AF with an absolute contraindication to OAT or at high bleeding risk. Follow-up was done with a clinical visit at 3-6-12 months. Results. Successful LAAO was achieved in 67/68 patients. At discharge, 32/68 patients were on dual antiplatelet therapy (APT), 34/68 were without any antithrombotic therapy or with a single antiplatelet drug, and 2/68 were on anticoagulant therapy. At three-month follow-up visit, 73.6% of the patients did not receive dual APT, of whom 14.7% had no thrombotic therapy and 58.9% were on single antiplatelet therapy. During a follow-up of 1.4 ± 0.9 years, 3/62 patients had late adverse effects (2 device-related thrombus without clinical consequences and 1 extracranial bleeding). The device-related thrombosis was not related to the antithrombotic therapy. Conclusions. LAAO is feasible and safe and prevents stroke in patients with AF with contraindication to oral anticoagulant therapy. After LAAO, single antiplatelet therapy seems to be a safe alternative to dual antiplatelet therapy, especially in patients at high bleeding risk. No benefit has been observed with dual APT.http://dx.doi.org/10.1155/2019/6704031 |
| spellingShingle | Pierluigi Merella Giovanni Lorenzoni Alessandro P. Delitala Filomena Sechi Federica Decandia Graziana Viola Paola Berne Gianluca Deiana Patrizio Mazzone Gavino Casu Left Atrial Appendage Occlusion in High Bleeding Risk Patients Journal of Interventional Cardiology |
| title | Left Atrial Appendage Occlusion in High Bleeding Risk Patients |
| title_full | Left Atrial Appendage Occlusion in High Bleeding Risk Patients |
| title_fullStr | Left Atrial Appendage Occlusion in High Bleeding Risk Patients |
| title_full_unstemmed | Left Atrial Appendage Occlusion in High Bleeding Risk Patients |
| title_short | Left Atrial Appendage Occlusion in High Bleeding Risk Patients |
| title_sort | left atrial appendage occlusion in high bleeding risk patients |
| url | http://dx.doi.org/10.1155/2019/6704031 |
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