Author + information
- Chen Yanhong,
- Zhang Yonghua,
- Huang Weiping,
- Huang Keqiang,
- Xu Bei and
- Su Xi
Atrial fibrillation (AF) is associated with increased risk for stroke from cardiac embolism of the left atrial appendage (LAA). Percutaneous LAA closure is a novel and powerful treatment for stroke prevention in AF. However, observations of primary and secondary stroke preventions with LAA closure in Chinese patients has until now, been limited. this retrospective single center study was designed to evaluate the feasibility and safety of LAA closures in non-valvular AF patients in mainland China.
From 2014 to 2015, non-valvular AF patients at high risk of stroke with or without previous stroke were selected for LAA closure and outcome observations analyzed.
LAA closure with Watchman devices were attempted in 119 115 patients, of which, 114 were successful (99%). A total of 115 devices were implanted, with one patient implanted with 2 devices due to two large lobes of the LAA. The mean CHA2DS2-VASc score was 2.77 ± 1.51 and the mean HASBLED score was 1.46 ± 0.98. No deaths occurred following implantations of the devices. Major safety events occurred in 3 patients (2.61%), of which, 2 were device-related cerebral embolisms, and 1 was a case of pericardial tamponade that required emergent surgery. Trans-esophageal echocardiography (TEE) were performed 45 days after implantation, which showed no major residual flow (i.e., >5mm). Two patients had thromboi-formations on the devices and received prolonged warfarin therapy. The remaining 112 patients discontinued warfarin after 45days, and our follow-up of 12 months, reported no stroke or major bleeding.
In our initial single-center experience, percutaneous LAA closure was a feasible and safe procedure that helped to prevent stroke in Chinese patients with non-valvular AF.