Document Detail


Left atrial appendage closure for stroke prevention in atrial fibrillation: state of the art and current challenges.
MedLine Citation:
PMID:  17653115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial fibrillation (AF) is a major risk factor for disabling ischemic strokes. Anticoagulation is highly effective for stroke prevention in patients with AF, but a substantial number of patients are unable to sustain chronic therapy with warfarin. Most strokes in patients with AF are thought to arise from thrombus formation in the left atrial appendage (LAA); therefore, occlusion of the orifice of the LAA provides a theoretically appealing option for stroke prevention. Surgical exclusion of the LAA is increasingly performed in patients undergoing open-heart surgery, and thoracoscopic epicardial occlusion of the LAA has yielded promising early results. Percutaneous LAA occlusion devices have shown some success initial trials, but additional safety and efficacy data are required before this approach can be routinely considered. Here we discuss the LAA in relation to AF-related embolic stroke, and how LAA occlusion devices could be used in stroke prevention in patients who cannot tolerate chronic anticoagulant therapy.
Authors:
Tariqshah M Syed; Jonathan L Halperin
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nature clinical practice. Cardiovascular medicine     Volume:  4     ISSN:  1743-4300     ISO Abbreviation:  -     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-26     Completed Date:  2007-09-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101226507     Medline TA:  Nat Clin Pract Cardiovasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  428-35     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Zena and Michael A Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY 10029-6574, USA.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use
Atrial Appendage / pathology,  surgery*
Atrial Fibrillation / complications,  surgery*
Cardiac Surgical Procedures / instrumentation*
Clinical Trials as Topic
Humans
Risk Factors
Stroke / etiology,  prevention & control*,  surgery*
Thoracoscopy
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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