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Left atrium is the main site originating thrombus formation in patients with atrial fibrillation (AF) and accounts for approximately 90% of AF-related stroke. Therefore, a novel clinical practice, left atrial appendage closure (LAAC), and related apparatus have been developed to keep thrombus in left atrium from flowing into systemic circulation and thus prevent AF-related stroke. The present study applied LAAC with a new type of LAA occluder on patients with congenital heart disease (including atrial septal defect and patent foramen ovale) and AF, and evaluate the feasibility, safety and outcome of this clinical application in short- to medium-termed follow-up.
A total of 7 patients were selected and received LAAC guided by transesophageal echocardiography (TEE), and simultaneously interatrial communication occlusion. Therapeutic effects, including the location of left atrium and interatrial occlude, thrombus formation and residual shunts, were sequentially evaluated immediately, 30 days or 90 days post-procedure.
All patients successfully received implantation of LAC occluder. 6 patients received simultaneously atrial septal defect or patent foramen ovale occlusion. Post-procedural examination showed that the occluder was located appropriately and secured well. No complications such as residual shunts, cardiac tamponade, thrombus formation or hemorrhage were found. Follow-up data showed good cardiac function, stable occluder shape, no signs of thrombus formation or residual shunts around the edge of occluder.
The clinical application of LAAC on patients with CHD (including atrial septal defect and patent foramen ovale) and AF is convenient and safe. The therapeutic effect is convincible and outcome of short- to medium-termed follow-up achieves satisfying results.