Faisabilité de l'exclusion percutanée de l'auricule gauche: À propos de 11 cas

Translated title of the contribution: Feasibility of percutaneous exclusion of the left atrial appendage: Results in 11 cases

Dominique Himbert, A. Cachier, E. Brochet, M. Majdoub, J. M. Olivot, Ph Lavallée, J. M. Serfaty, P. Amarenco, A. Vahanian

Research output: Contribution to journalArticlepeer-review

Abstract

Atrial fibrillation is associated with a risk of cerebral embolism, the only proven effective prevention of which is anticoagulant therapy. There is no known alternative in cases with contra-indications to this treatment. Percutaneous exclusion of the left atrial appendage by the implantation of a prosthesis (PLAATO System. ev3 Inc., Plymouth, Minnesota) is a new approach to the prevention of these complications. The authors report the results observed in a series of 11 consecutive patients (7 men, mean age 72 ± 9 years) in whom this procedure was proposed. All patients had atrial fibrillation for over 3 months, were at high risk and had contra-indications to oral anticoagulants. The implantation of the prosthesis was performed after treatment with aspirin and clopidogrel, under general anaesthesia radioscopy and transoesophageal echocardiographic guidance with success in 9 cases (1 implantation refused in the catheter laboratory and 1 failure). The only complication observed was transient ST elevation treated by emergency angioplasty. The echographic and angiographic criteria of success of left atrial appendage exclusion were fulfilled in all implanted patients. The hospital course was uncomplicated. One recurrence of stroke was observed at the second month: transoesophageal echocardiography confirmed the absence of thrombosis, of migration of the prosthesis and its impermeability in all the patients. After 7 ± 5 months' follow-up, no other adverse event was observed. This new procedure is technically feasible. Despite encouraging results, its long-term efficacy in the prevention of thromboembolic complications of atrial fibrillation remains to be demonstrated.

Translated title of the contributionFeasibility of percutaneous exclusion of the left atrial appendage: Results in 11 cases
Original languageFrench
Pages (from-to)585-592
Number of pages8
JournalArchives des Maladies du Coeur et des Vaisseaux
Volume99
Issue number6
StatePublished - Jun 2006
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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