Left atrial appendage closure - Current status and future directions

Prog Cardiovasc Dis. 2021 Nov-Dec:69:101-109. doi: 10.1016/j.pcad.2021.11.013. Epub 2021 Nov 27.

Abstract

Percutaneous left atrial appendage closure (LAAC) has become an important non-pharmacological intervention for stroke prevention in patients with non-valvular atrial fibrillation (AF). LAAC aims to reduce the risk of thromboembolism without increasing the risk of bleeding, a crucial strategy for patients at high risk for bleeding. Over the last few decades, the safety and long-term efficacy of the procedure in specific populations have grown, and more patients are being treated with these devices. Current and future studies focus on expanding the target population as well as the iteration of current technology. This article reviews recent, present, and future LAAC studies on the two most common devices, the Watchman device (Boston Scientific Corporation) and the Amplatzer cardiac plug (ACP) (St. Jude Medical, Minneapolis, MN), and their subsequent next generations, the Watchman FLX, and the Amulet, respectively.

Keywords: Amulet; Atrial fibrillation; Left atrial appendage; Oral anticoagulation; Thromboembolism; Watchman.

Publication types

  • Review

MeSH terms

  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / surgery
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / trends
  • Hemorrhage / chemically induced
  • Humans
  • Stroke / prevention & control
  • Treatment Outcome