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Left Atrial Appendage Closure – Techniques and Devices

  • Marius Hornung
  • Jennifer Franke
  • Sameer Gafoor
  • Horst SievertEmail author
Chapter

Abstract

The history of percutaneous occlusion of the left atrial appendage (LAA) for stroke prevention started back in 2001 with the first implantation of the percutaneous LAA transcatheter occlusion system (PLAATO; Appriva Medical, Sunnyvale, CA, USA) [1]. The PLAATO device was a self-expanding nitinol cage covered with a polytetrafluoroethylene membrane, anchoring in the LAA using hooks positioned on the struts of the cage (Fig. 17.1). Despite favorable clinical results with an annual ischemic stroke rate substantially lower than predicted by CHADS2 score (3.8 % vs. 6.6 %) [2], the manufacturer discontinued the development of the device in 2006. This was the result of the strict and therefore costly requirements of the FDA, which is why approval of the occluder on the American market did not appear possible. But the development of other endo- and epicardial systems for LAA closure continued. This section presents requirements and techniques for the occlusion of the LAA considering commercially available devices to which CE Mark or FDA approval was granted.

Keywords

Left Atrial Appendage Landing Zone Transseptal Puncture Delivery Catheter Access Sheath 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

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    Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374(9689):534–42.CrossRefPubMedGoogle Scholar
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    Reddy VY, Mobius-Winkler S, Miller MA, et al. Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology). J Am Coll Cardiol. 2013;61(25):2551–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Marius Hornung
    • 1
  • Jennifer Franke
    • 1
  • Sameer Gafoor
    • 1
  • Horst Sievert
    • 1
    Email author
  1. 1.CardioVascular Center FrankfurtFrankfurtGermany

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