Percutaneous Left Atrial Appendage Closure Using an Occluder Device: A Single Center Experience

Background: Left atrial appendage (LAA) is the main source of thrombus formation, and occlusion of this structure decreases the risk of stroke in patients with atrial fibrillation. Objectives: We aimed to describe the feasibility, safety and outcomes of percutaneous LAA closure using an occluder device, and to evaluate residual LAA contrast leak detected on computed tomography (CT) imaging in patients who underwent implantation in our institution. Methods: Consecutive patients of Taipei Veterans General Hospital who underwent percutaneous implantation of an LAA occluder (LAAO) were retrospectively collected and analyzed. Results: A total of 23 patients were included with a median age of 67 years (42-87) and median CHA_2DS_2-VASc score of 4 (1-7). The most frequent indication for intervention was bleeding while on oral anticoagulation treatment. After a mean follow-up of 31.17 ± 25.10 months, successful device implantation was achieved in 95.7% of the patients. There was no occurrence of death, stroke, device embolization, acute ST elevation myocardial infarction, major bleeding requiring invasive treatment or blood transfusion, inguinal hematoma or major bleeding related to antiplatelet therapy. One patient had cardiac tamponade, 1 had intra-procedural thrombus formation, 1 had impingement of mitral valve leaflet, and 1 had device-related thrombosis. Of 12 patients who underwent CT post-implantation, 6 had residual contrast leak into the LAA, one third of those who had peri-device leak. Conclusions: Percutaneous implantation of an LAAO appeared to be feasible with a low risk of major complications.