A decade of left atrial appendage closure: from procedural data to long-term clinical benefit

ABSTRACT Introduction and objectives: A better positioning of left atrial appendage closure (LAAC) requires assessment of its clinical benefits to reduce thromboembolic and bleeding events in a real-word population. Methods: Single-center retrospective study of our consecutive LAAC activity for 9 ye...

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Veröffentlicht in:REC, Interventional cardiology (Internet. English ed.) Interventional cardiology (Internet. English ed.), 2021-04, Vol.3 (2), p.112-118
Hauptverfasser: Ruiz-Salmerón, Rafael J., Ronquillo-Japón, María, Robles-Pérez, Carlos, Iglesias-Blanco, Manuel, Rubio-Iglesias, Carlos, la Borbolla, Rafael García de, Carrascosa-Rosillo, César, de Leiras, Sergio Rodríguez, Vizcaíno-Arellano, Manuel, Méndez-Santos and, Irene, Polo-Padillo, Juan
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Sprache:eng
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Zusammenfassung:ABSTRACT Introduction and objectives: A better positioning of left atrial appendage closure (LAAC) requires assessment of its clinical benefits to reduce thromboembolic and bleeding events in a real-word population. Methods: Single-center retrospective study of our consecutive LAAC activity for 9 years. Both the device success and procedural success were registered as well as the reduction of the expected rates of thromboembolic and major bleeding events. Results: A total of 260 LAAC procedures were performed in a population with nonvalvular atrial fibrillation with CHA2DS2-VASc and HAS-BLED scores of 4.3 ± 1.6 and 3.7 ± 1.2, respectively. Procedural success was 98.8%, and the rate of serious adverse events within the first 7 days was 2.3%. At a median follow-up of 2.5 ± 1.9 years and an estimated population of 637.9 patients-year, the thromboembolic event rate was 1.4 per 100 patients-year (75.5% risk reduction) and the rate of major bleeding was 3.0 per 100 patients-year (58.5% risk reduction), which was significantly lower than anticipated. The thromboembolic and major bleeding events per 100 patients-year showed a lower tendency for patients with very long follow-up (over 4 years) compared to the remaining of the population (0.7 vs 2.0 with P = .17, and 1.7 vs 4.0 with P = .09, respectively). Conclusions: In our population, the LAAC showed high procedural success and a low rate of periprocedural adverse events. LAAC induced a significant reduction in the rate of predicted thromboembolic and hemorrhagic events, and this reduction was maintained even at very long follow-up.
ISSN:2604-7322
2604-7322
DOI:10.24875/RECICE.M20000187