Risks and Benefits of Removal of the Left Atrial Appendage.

Abstract

PURPOSE OF REVIEW:

In patients with atrial fibrillation who are unable to take novel oral anticoagulants for stroke prophylaxis due to bleeding risk or other contraindications, left atrial appendage (LAA) occlusion and exclusion devices have shown benefit. In this review, we highlight the risks and benefits associated with LAA removal.

RECENT FINDINGS:

LAA, once considered a vestigial organ, has been shown to have physiological, anatomical, and arrhythmogenic properties. Device-related complications such as pericardial effusion, device embolization, device-related thrombus, while uncommon, are still present. With increased operator experience related to appendage occlusion, overall procedural complications have declined. Further refinements in device technology will help decrease complications. While benefits of appendage removal are plenty, procedural complications need to be weighed into the equation when making decisions regarding LAA occlusion.

• Authors: Ghulam Murtaza, Urooge Boda, Mohit K Turagam, Domenico G Della Rocca, Krishna Akella, Rakesh Gopinathannair, Dhanunjaya Lakkireddy
• Journal: Current cardiology reports (Curr Cardiol Rep) Vol. 22 Issue 11 Pg. 129 (09 10 2020) ISSN: 1534-3170 [Electronic] United States
• PMID: 32910248 (Publication Type: Journal Article, Review)

Chemical References

• Anticoagulants

Topics

• Anticoagulants (therapeutic use)
• Atrial Appendage (surgery)
• Atrial Fibrillation (complications)
• Humans
• Risk Assessment
• Stroke (etiology, prevention & control)
• Treatment Outcome