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Article Dans Une Revue Archives of cardiovascular diseases Année : 2015

Percutaneous occlusion of the left atrial appendage: An expert consensus statement.

Résumé

Atrial fibrillation (AF) is the most common rhythm disturbance. Among the major thromboembolic complications associated with AF, strokes are foremost, with a 4.4% yearly incidence in the absence of preventive treatment. Therefore, the prevention of these embolic accidents is a priority. While proof of the efficacy of oral anticoagulants (OACs) for this indication is long-standing and convincing, they are associated with haemorrhagic complications. Consequently, their prescription is based on an estimate of the risk (haemorrhagic complications)/benefit (thromboembolic prevention) ratio. In a patient subset at high thromboembolic and haemorrhagic risk, whether to prescribe or abstain from prescribing an OAC is a challenging decision, and an alternative means of thromboembolic prevention is desirable. Percutaneous occlusion of the left atrial appendage (LAA) is an alternative, interventional, non-pharmacological treatment that has been used widely in Europe and for a few years in France, with encouraging results. However, it remains an invasive procedure with a low level of proof in comparison with OACs. Moreover, the indications, the procedural environment and pre-per-post procedural patient management are major questions about this technique, with consequences on its efficacy and risk/benefit ratio. This document, composed by consensus among experts in the field, is an in-depth review of this new therapy.

Dates et versions

hal-01763916 , version 1 (11-04-2018)

Identifiants

Citer

Didier Klug, Philippe Commeau, Pascal Defaye, Jean-Benoit Thambo, Daniel Gras, et al.. Percutaneous occlusion of the left atrial appendage: An expert consensus statement.. Archives of cardiovascular diseases, 2015, pp.460-7. ⟨10.1016/j.acvd.2015.02.001⟩. ⟨hal-01763916⟩
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