Indications, evidence, and controversy in the closure of the left atrial appendage

Giuseppe Patti; Chiara Ghiglieno

doi:10.1093/eurheartjsupp/suad091

Indications, evidence, and controversy in the closure of the left atrial appendage

Eur Heart J Suppl. 2023 Apr 21;25(Suppl B):B126-B130. doi: 10.1093/eurheartjsupp/suad091. eCollection 2023 Apr.

Authors

Giuseppe Patti^{1

2}, Chiara Ghiglieno^{1

2}

Affiliations

¹ Cardiovascular Department, Amadeo Avogadro University of Eastern Piedmont, Novara, Italy.
² Cardiovascular Department, Major Hospital of Charity, Novara, Italy.

Abstract

Closure of the left atrial appendage (LAAO) represents a valid option for the prevention of cardio-embolic stroke in patients with atrial fibrillation (AF) at high bleeding risk. Previous studies had shown that the atrial appendage represents the site of atrial thrombus formation in about 90% of cases in the presence of non-valvular AF. In all patients with AF and higher thromboembolic risk (in particular with CHA2DS2VASc score ≥2 in women and ≥1 in men) there is an indication for thromboembolic prophylaxis with AOC (oral anti-coagulants). The main guidelines and international consensus documents place the indication for the LAAO in patients with the need for thromboembolic prophylaxis who have contraindications to oral anticoagulant therapy (class of recommendation IIb).

Keywords: Atrial fibrillation; Cardioembolic stroke; Closure of the left auricle.