Key result
Left atrial appendage occlusion can be safely performed in patients with a prior intra-atrial septal closure device by performing transseptal puncture inferior and posterior or anterior to the device.
Why the study?
The presence of an atrial septal closure device was previously considered a relative contraindication to left atrial appendage occlusion.
Can left atrial appendage occlusion be safely performed in a patient with a prior patent foramen ovale occlusion device?
Case Report (n=1)
Can left atrial appendage occlusion be safely performed in a patient with a prior patent foramen ovale occlusion device?
Answers are grounded in this paper and cite their sources.
LAA occlusion is feasible and safe in patients with a preexisting atrial septal closure device, challenging the notion that it is a relative contraindication.
Key Teaching Points•Left atrial appendage (LAA) occlusion has been presented as a noninferior therapeutic option in patients with nonvalvular atrial fibrillation.•The presence of an atrial septal closure device previously has been considered a relative contraindication to LAA occlusion, but LAA occlusion can be safely performed in patients with a prior intra-atrial septal closure device.•Transseptal puncture preferably should be made inferior and posterior to the preexisting atrial septal defect or patent foramen ovale device. However, it is possible to safely perform transseptal puncture inferior and anterior to the device. •Left atrial appendage (LAA) occlusion has been presented as a noninferior therapeutic option in patients with nonvalvular atrial fibrillation.•The presence of an atrial septal closure device previously has been considered a relative contraindication to LAA occlusion, but LAA occlusion can be safely performed in patients with a prior intra-atrial septal closure device.•Transseptal puncture preferably should be made inferior and posterior to the preexisting atrial septal defect or patent foramen ovale device. However, it is possible to safely perform transseptal puncture inferior and anterior to the device.
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Nadel et al. (2018) conducted a case report in Nonvalvular atrial fibrillation with prior patent foramen ovale occlusion (n=1). Left atrial appendage occlusion was evaluated. Left atrial appendage occlusion can be safely performed in patients with a prior intra-atrial septal closure device by performing transseptal puncture inferior and posterior or anterior to the device.
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