Current Cardiology Reports

, 16:448

Left Atrial Appendage Exclusion for Prevention of Stroke in Atrial Fibrillation: Review of Minimally Invasive Approaches

Echocardiography (RM Lang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Echocardiography

Abstract

Stroke prevention is of vital importance in the management of atrial fibrillation (AF), though the proven strategy of systemic anticoagulation for thromboembolic prophylaxis is underutilized for a variety of reasons. The left atrial appendage (LAA) has long been suspected as the principal source of arterial emboli, particularly in nonvalvular AF, and a variety of techniques for its exclusion from the circulation have been developed. This review highlights the history of the LAA as a target of intervention, and the parallel advances in three minimally invasive strategies for its exclusion: percutaneous occlusion of the LAA orifice from within the left atrium, closed-chest ligation via a percutaneous pericardial approach, and minimally invasive thoracoscopic surgery. While further study is necessary, available evidence suggests that effective LAA exclusion is becoming a viable alternative to anticoagulation for stroke prevention in nonvalvular AF.

Keywords

Atrial fibrillation Stroke Anticoagulation Left atrial appendage occlusion Left atrial appendage ligation Left atrial appendage exclusion Percutaneous closure of left atrial appendage WATCHMAN Amplatzer Cardiac Plug LARIAT suture delivery device 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Section of Cardiology, Department of Internal MedicineUniversity of ChicagoChicagoUSA

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