Abstract | AIMS: Percutaneous transcatheter device closure of left atrial appendage (LAA), patent foramen ovale (PFO) and atrial septal defect (ASD) are usually performed with unfractionated heparin anticoagulation. We report a first experience using intravenous (IV) enoxaparin without anticoagulation monitoring in transcatheter structural heart interventions performed in the left atrium (LA). METHODS AND RESULTS: This retrospective, non-controlled study included all consecutive and unselected patients who underwent percutaneous LAA, PFO or ASD closure at a tertiary care centre using IV enoxaparin anticoagulation. The primary composite endpoint was the occurrence of in-hospital death, embolic complications ( stroke, transient ischaemic attack, and peripheral arterial embolism) and bleedings defined as type 3a or more according to the BARC definitions. We enrolled 198 patients (mean age 60±18 years, 55% male) with an indication for LAA (40.4%), PFO (34.3%) or ASD closure (25.3%). The majority of patients (n=163, 82%) received a single IV enoxaparin dose of 0.5 mg/kg. The composite endpoint occurred in six (3%) patients including four (2%) type 3a bleedings, one (0.5%) transient ischaemic attack and one (0.5%) death from sepsis. CONCLUSIONS: IV enoxaparin without monitoring appears to be a potentially safe and easy-to-use anticoagulation regimen in percutaneous LA cardiac interventions. Further investigations with larger cohorts of patients are warranted.
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Authors | Paul Guedeney, Nadjib Hammoudi, Guillaume Duthoit, Yan Yan, Johanne Silvain, Françoise Pousset, Richard Isnard, Alban Redheuil, Mathieu Kerneis, Jean-Philippe Collet, Gilles Montalescot |
Journal | EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
(EuroIntervention)
Vol. 13
Issue 10
Pg. 1226-1233
(Nov 20 2017)
ISSN: 1969-6213 [Electronic] France |
PMID | 28804058
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Atrial Appendage
(surgery)
- Atrial Fibrillation
(therapy)
- Cardiac Catheterization
(methods)
- Cardiac Surgical Procedures
(methods)
- Enoxaparin
(therapeutic use)
- Female
- Foramen Ovale, Patent
(surgery)
- Heart Atria
(surgery)
- Heparin
(therapeutic use)
- Humans
- Male
- Middle Aged
- Septal Occluder Device
- Thrombolytic Therapy
(methods)
- Treatment Outcome
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