Document Detail


Percutaneous left atrial appendage transcatheter occlusion (PLAATO) for stroke prevention in atrial fibrillation: 2-year outcomes.
MedLine Citation:
PMID:  19726815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In more than 90% of patients with atrial fibrillation (AF), stroke is due to thrombotic embolization from the left atrial appendage (LAA). Transcatheter occlusion with percutaneous left atrial appendage transcatheter occlusion (PLAATO), a self-expanding, membrane- covered spherical nitinol cage, is feasible and an alternative to anticoagulation therapy. METHODS: This was a single-center prospective registry study for verification of stroke risk reduction in patients with AF 2 years after PLAATO. RESULTS: Seventy-three patients with AF (permanent 65, paroxysmal 8) in whom anticoagulation therapy was contraindicated or rejected underwent transcatheter LAA occlusion with PLAATO. One patient died periprocedurally due to implant embolization, and 1 patient underwent open-heart surgery because of implant instability. The remaining 71 patients were followed for 24 months. In 52 patients a stable anchoring of the PLAATO device without migration or dislocation was documented by transesophageal echocardiography (TEE). No thrombotic deposition was found on the LA luminal surface of the device. Statistically, in our patient cohort, 7 strokes would have been expected without any treatment within 24 months. In fact, no strokes were reported. Ten out of 71 patients died during follow up: 6 in our hospital and 4 at home. None of them died from a stroke. CONCLUSIONS: Ninety-seven percent of AF patients were successfully treated with PLAATO. After mechanical LAA occlusion, the 2-year risk of stroke in AF patients is markedly reduced. Therefore, this therapeutic concept is a clear alternative for patients with AF and contraindications for oral anticoagulation.
Authors:
Jai-Wun Park; Boris Leith?user; Ulrich Gerk; Martin Vrsansky; Friedrich Jung
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  21     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-03     Completed Date:  2010-01-28     Revised Date:  2010-03-29    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  446-50     Citation Subset:  IM    
Affiliation:
Hoyerswerda Hospital, 1st Medical Department, Cardiology, Angiology, Nephrology, Academic Teaching Hospital of the Technical University of Dresden, Hoyerswerda, Germany. jai-wunpark@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alloys
Angioplasty, Balloon / instrumentation,  methods*
Anticoagulants / contraindications
Atrial Fibrillation / therapy*
Female
Follow-Up Studies
Heart Catheterization / instrumentation,  methods*
Humans
Male
Middle Aged
Prospective Studies
Prostheses and Implants / adverse effects
Registries
Retrospective Studies
Risk Factors
Stroke / epidemiology,  etiology,  prevention & control*
Thromboembolism / complications
Treatment Outcome
Chemical
Reg. No./Substance:
0/Alloys; 0/Anticoagulants; 52013-44-2/nitinol

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


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