Transcatheter Left Atrial Appendage Occlusion in Atrial Fibrillation: Comparison of Non-Dedicated Versus Dedicated Amplatzer Devices Steffen Gloekler, Michael Schmid, Ardan M. Saguner, Ahmed A. Khattab, Andreas Wahl, Peter Wenaweser, Stephan Windecker, and Bernhard Meier Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Switzerland 1
15
Embed
Transcatheter left atrial appendage occlusion in atrial
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Transcatheter Left Atrial Appendage
Occlusion in Atrial Fibrillation:
Comparison of Non-Dedicated Versus
Dedicated Amplatzer Devices
Steffen Gloekler, Michael Schmid, Ardan M. Saguner, Ahmed A. Khattab, Andreas Wahl,
Peter Wenaweser, Stephan Windecker, and Bernhard Meier
Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Switzerland
1
Speaker’s name: Steffen Gloekler
I do not have any potential conflict of interest
Potential conflicts of interest
Atrial fibrillation & stroke
• 25% of persons >40 years will develop atrial fibrillation (AF)
• Overall risk for stroke in non-anticoagulated patients with AF: ∼5% per year
• Stroke risk ↑ with CHADS2 Score up to 18% per year
• 20% of strokes are lethal
• Long-term warfarine: standard of care
3
>90% of thrombi
originate from LAA*
Blackshear et al, Ann Thorac Surg 1996 Alberg et al, Acta Med Scand 1969 Stoddard et al , JACC 1995
* LAA = Left Atrial Appendage
Blackshear et al, Ann Thorac Surg 1996 Alberg et al, Acta Med Scand 1969 Stoddard et al, JACC 1995
* LAA = Left Atrial Appendage
* LAA = Left Atrial Appendage
Rationale for LAA occlusion
• Limitations of standard therapy
• Risk reduction for thrombi of 90%
• Contraindication for OAC
• Obviation of long-term OAC
• Solution for patients unwilling to take OAC
4
2002Watchman
2001
PLAATO
Devices for LAA occlusion
5
2008Amplatzer
CardiacPlug
Previous Data from LAA occlusion
6
Proof of concept !!
Methods
• Oberservational, single center study
• Patients with nonvalvular AF
• Comparison of 32 patients with NDA* vs 32 with ACP **
• Local anesthesia, femoral venous-transseptal access