Feasibility of left atrial appendage closure in patients with persistent left atrial appendage thrombus:a systematic analysis
10.3969/j.issn.1004-8812.2024.04.005
- VernacularTitle:左心耳血栓持续存在患者行左心耳封堵术的可行性:系统性分析
- Author:
Fang DU
1
;
Cheng JIANG
;
Yang-Yang YU
;
Feng ZHAO
;
Hao HU
Author Information
1. 兰州大学第二医院(第二临床医学院)心血管内科,甘肃兰州 730030
- Keywords:
Atrial fibrillation;
Left atrial appendage thrombus;
Anticoagulants;
Left atrial appendage closure;
Systematic analysis
- From:
Chinese Journal of Interventional Cardiology
2024;32(4):211-219
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility of left atrial appendage closure(LAAC)in patients with atrial fibrillation combined with persistent left atrial appendage(LAA)thrombus.Methods The authors searched PubMed,EBSCO,CNKI and WANFANG DATA for all abstracts or full-text articles investigating LAAC in patients with atrial fibrillation combined with persistent LAA thrombus from 1 January 2000 to 1 June 2023.Baseline clinical characteristics,procedure-related data and perioperative complications,and clinical outcomes at follow-up were collected.The pooled data were analysed.Results 278 patients with atrial fibrillation combined with persistent LAA thrombus were retrospectively included.The average age was 73.2 years,58.6％male,the mean CHA2DS2-VASc and HAS-BLED scores was(4.62±1.23)and(3.28±0.94),respectively.In patients with previous stroke,ischaemic stroke/transient ischaemic attack(TIA)accounted for 74.8％.Most of the patients had a distally located thrombus in the LAA.All cases underwent successful implantation of LAAC devices with some procedural modifications.Amulet was the most commonly used device(65％).A cerebral protection device was used in 118(42.4％)patients.Most LAAC procedures were underwent with some technical modifications.One TIA(0.36％)and 3(1.08％)mild pericardial effusion that did not require drainage occurred post-procedure.There were 3 major bleeding events,and 2 of them required blood transfusion.The mean follow-up was(6.2±7.1)months,with 238 patients followed up.The all-cause mortality was 1.68％(4/238).Four ischemic strokes(4/238,1.68％)and 12(12/238,5.04％)device-related thrombus were noted during the follow-up.Conclusions Percutaneous LAAC procedures appear to be feasible in patients with persistent LAA thrombus when performed by experienced operators with some technical modifications and chose appropriate type of closure device according to the location of thrombus in the LAA.
