Percutaneous left atrial appendage occlusion

Authors: Petriy V.V., Maksimkin D.A., Petriy V.V., Shugushev Z.Kh.

Company: 1 Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation
2 Federal State Autonomous Institution “National Medical Research Center" Treatment and Rehabilitation Center”, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2022-16-2-189-198

For citation: Petriy V.V., Maksimkin D.A., Petriy V.V., Shugushev Z. Kh. Percutaneous left atrial appendage occlusion. Creative Cardiology. 2022; 16 (2): 189–198 (in Russ.). DOI: 10.24022/1997-3187-2022-16-2-189-198

Received / Accepted:  03.03.2022 / 20.06.2022

Keywords: atrial fibrillation left atrial appendage occlusion anticoagulant therapy thromboembolic complications ischemic stroke hemorrhagic complications leaks



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Abstract

Atrial fibrillation (AF) is the most common heart rhythm disturbance in the world. The presence of AF is associated with an increased risk of death, ischemic stroke, systemic embolism, myocardial infarction and heart failure. Cardioembolic stroke is considered to be the most feared complication of AF, which is accompanied by greater disability and mortality than other types of ischemic stroke. Anticoagulant therapy contributes to a decrease in the risk of thromboembolic complications, but patient adherence to it remains low; in addition, anticoagulants significantly increase the risk of hemorrhagic complications. It should be noted that about 2% of patients have absolute contraindications to anticoagulant therapy. In the vast majority of cases, the left atrial appendage is the main thrombogenic heart cavity in AF patients. Percutaneous left atrial appendage occlusion is aimed at preventing both thromboembolic and hemorrhagic complications, since after successful exclusion of this heart cavity from the systemic circulation, it is possible to use more sparing antithrombotic therapy regimens up to the complete abolition of anticoagulant therapy. This article presents a literature review of current studies on the problem of the left atrial appendage isolation, analyzes the main advantages and disadvantages of this technique, and identifies possible directions for future research.

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About Authors

  • Vladimir V. Petriy, Postgraduate; ORCID
  • Daniil A. Maksimkin, Cand. Med. Sci., Associate Professor; ORCID
  • Vladimir V. Petriy, Dr. Med. Sci., Head of the Department; ORCID
  • Zaurbek Kh. Shugushev, Dr. Med. Sci., Associate Professor, Chief of Chair; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery