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Risks and Benefits of Removal of the Left Atrial Appendage

Authors
  • Murtaza, Ghulam1
  • Boda, Urooge1
  • Turagam, Mohit K.2
  • Della Rocca, Domenico G.3
  • Akella, Krishna1
  • Gopinathannair, Rakesh1
  • Lakkireddy, Dhanunjaya1
  • 1 Overland Park Regional Medical Center, HCA MidWest, 12200, W 106th Street, Overland Park, KS, 66215, USA , Overland Park (United States)
  • 2 Icahn School of Medicine at Mount Sinai, New York, NY, USA , New York (United States)
  • 3 St. David’s Hospital, Austin, TX, USA , Austin (United States)
Type
Published Article
Journal
Current Cardiology Reports
Publisher
Springer-Verlag
Publication Date
Sep 10, 2020
Volume
22
Issue
11
Identifiers
DOI: 10.1007/s11886-020-01387-x
Source
Springer Nature
Keywords
License
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Abstract

Purpose of ReviewIn 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 FindingsLAA, 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.SummaryWhile benefits of appendage removal are plenty, procedural complications need to be weighed into the equation when making decisions regarding LAA occlusion.

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