tailieunhanh - Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2

(BQ) Part 2 book "Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation" presents the following contents: Percutaneous LAA closure devices and trial results, post procedural management and issues. | Part IV Percutaneous LAA Closure Devices and Trial Results Chapter 9 PLAATO Device Randall J. Lee Introduction Atrial fibrillation AF is the most prevalent cardiac arrhythmia in the United States and is associated with a fivefold increase in cardioembolic events 1-3 . There is a higher mortality and morbidity associated with cardioembolic strokes associated with AF compared to non-AF strokes emphasizing the need for preventive treatment strategies 4 . The left atrial appendage LAA has been long recognized as the primary source of thrombus formation within the cardiovascular system 4-6 and has been termed the most lethal human attachment 14 . In surgical patients with AF left atrial LA thrombus was found in 17 of nonrheumatic AF patients however 91 201 of 222 patients of the thrombus was localized to the LAA 7 . These findings were corroborated by transesophageal echocardiography evaluation of patients undergoing cardioversion where LA thrombus is predominantly located in the LAA 8-10 . These observations led to the hypothesis that closure of the LAA would prevent thrombus formation prevent cardioembolic events and reduce mortality. The concept of excluding the LAA during mitral valve surgery existed since the 1930s 5 6 and has become an integral part of the American College of Cardiology American Heart Association guidelines for mitral valve surgery to reduce the stroke risk 11 12 . LAA exclusion is also an essential part of the Maze procedure for both stroke prevention and reduction of AF 13 . Many surgeons now advocate the removal of the LAA during any open-heart procedure 7 . The PLAATO Percutaneous Left Atrial Appendage Transcatheter Occlusion device was conceived and developed based on the premise that if the appendage could be . Lee . . University of California San Francisco 500 Parnassus Ave San Francisco CA 94010 USA e-mail Springer International Publishing Switzerland 2016 J. Saw et al. eds. Left Atrial Appendage Closure .