Interventional Stroke Prevention

By Fabian Nietlispach

Left atrial appendage occlusion (LAAO) has established as an alternative to oral anticoagulation. Ad hoc LAAO is a patient and resource friendly approach. It warrants reliable angiographic exclusion of thrombus in the left atrial appendage. We demonstrate feasibility of such an approach: LAAO was performed using fluoroscopic guidance and local anesthesia only (no transesophageal echocardiography or general anesthesia). A contrast injection into the left atrium was used to exclude thrombus in the left atrial appendage before entering it.

Our approach enables ad hoc LAAO for patients who undergo cardiac catheterization and are deemed candidates for LAAO at the time of intervention. Typical patients are those in atrial fibrillation undergoing PCI. They can avoid the risk of triple anticoagulant therapy.

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