Percutaneous LAAC guided by TEE under local anesthesia achieved a 95.6% successful occlusion rate with a 1.3% periprocedural major adverse event rate and 1.9/100 person-years ischemic stroke rate.
Observational (n=159)
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is usually performed under general anesthesia (GA) guided by transesophageal echocardiography (TEE), or under local anesthesia (LA) guided by intracardiac echocardiography (ICE). GA is known to carry some disadvantages. It is sometimes technically challenging to obtain adequate imaging of the left atrial appendage (LAA) with LAAC guided by ICE. This study aimed to assess the safety and clinical efficacy of LAAC guided by TEE under LA in patients with non-valvular atrial fibrillation (AF). METHODS: A total of 159 patients (70.5 ± 8.2 years; 66% male) with AF who had a high risk of stroke and bleeding or who had contraindications for oral anticoagulation underwent LAAC under LA. TEE or computed tomography (CT) follow-up was scheduled approximately 6 weeks after the procedure. Patients were followed to assess ischemic stroke and major bleeding events. RESULTS: The LAA was successfully occluded in 152 patients (95.6%). There were 2 (1.3%) periprocedural major adverse events. A total of 142 patients (93.4%) finished TEE or CT follow-up. Thrombus formation as seen on the device was documented in 2 patients. All of the LAAs were completely sealed with the absence of flow or with minimal flow. The median follow-up period was 522 days, resulting in a total of 216 patient-years. Ischemic stroke occurred in 4 patients. The annual ischemic stroke rate was 1.9/100 person-years. Major bleeding occurred in 2 patients. The annual major bleeding rate was 1.9/100 person-years. CONCLUSIONS: In this study, percutaneous LAAC using TEE under LA was safe and showed encouraging results for stroke prevention and major bleeding reduction.
Wang et al. (Mon,) conducted a observational in non-valvular atrial fibrillation (AF) (n=159). Percutaneous left atrial appendage closure (LAAC) guided by TEE under local anesthesia was evaluated on Successful occlusion, periprocedural major adverse events, ischemic stroke, and major bleeding. Percutaneous LAAC guided by TEE under local anesthesia achieved a 95.6% successful occlusion rate with a 1.3% periprocedural major adverse event rate and 1.9/100 person-years ischemic stroke rate.