Marian Burysz, Michalina Malec-Litwinowicz, Jakub Batko, Radoslaw Litwinowicz, Mariusz Kowalewski, Bogus Aw Kapelak, Krzysztof Bartus
{"title":"A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device.","authors":"Marian Burysz, Michalina Malec-Litwinowicz, Jakub Batko, Radoslaw Litwinowicz, Mariusz Kowalewski, Bogus Aw Kapelak, Krzysztof Bartus","doi":"10.5114/kitp.2023.134176","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Over the past decade, left atrial appendage occlusion (LAAO) has emerged as an established alternative to oral anticoagulation for patients diagnosed with atrial fibrillation (AF). The LARIAT device stands as the sole available epicardial system for complete percutaneous left atrial appendage (LAA) closure.</p><p><strong>Aim: </strong>To present the extended outcomes (spanning over 9 years of observation) in patients with AF who underwent epicardial LAAO. The presented results constitute the longest observation in world literature.</p><p><strong>Material and methods: </strong>A prospective, single-center study was conducted on 121 patients undergoing LAAO with the LARIAT system. Incidence of thromboembolic events and severe bleeding and mortality rates were documented. The reduction in the risk of thromboembolism and bleeding after LAAO was quantified.</p><p><strong>Results: </strong>The mean follow-up duration was 74.18 months. The average CHADS<sub>2</sub> score was 1.9 ±1.0, CHA<sub>2</sub>DS<sub>2</sub>-VAS score was 2.8 ±1.5, and HAS-BLED score was 2.7 ±1.0. The mean annual thromboembolic event rate was 0.7%, resulting in a 75% reduction in estimated thromboembolic risk. The annual occurrence of major bleeding complications was 0.8%, leading to a 67.9% reduction in estimated bleeding risk. The overall annual mortality rate was 1.2%.</p><p><strong>Conclusions: </strong>Epicardial LAAO employing the LARIAT device yields commendable long-term outcomes by reducing stroke and bleeding risk.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":null,"pages":null},"PeriodicalIF":0.6000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809813/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kardiochirurgia I Torakochirurgia Polska","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/kitp.2023.134176","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/11 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Over the past decade, left atrial appendage occlusion (LAAO) has emerged as an established alternative to oral anticoagulation for patients diagnosed with atrial fibrillation (AF). The LARIAT device stands as the sole available epicardial system for complete percutaneous left atrial appendage (LAA) closure.
Aim: To present the extended outcomes (spanning over 9 years of observation) in patients with AF who underwent epicardial LAAO. The presented results constitute the longest observation in world literature.
Material and methods: A prospective, single-center study was conducted on 121 patients undergoing LAAO with the LARIAT system. Incidence of thromboembolic events and severe bleeding and mortality rates were documented. The reduction in the risk of thromboembolism and bleeding after LAAO was quantified.
Results: The mean follow-up duration was 74.18 months. The average CHADS2 score was 1.9 ±1.0, CHA2DS2-VAS score was 2.8 ±1.5, and HAS-BLED score was 2.7 ±1.0. The mean annual thromboembolic event rate was 0.7%, resulting in a 75% reduction in estimated thromboembolic risk. The annual occurrence of major bleeding complications was 0.8%, leading to a 67.9% reduction in estimated bleeding risk. The overall annual mortality rate was 1.2%.
Conclusions: Epicardial LAAO employing the LARIAT device yields commendable long-term outcomes by reducing stroke and bleeding risk.
期刊介绍:
Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.