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LAA ligation using the LARIAT suture delivery device: Tips and tricks for a successful procedure

Published:January 23, 2014DOI:https://doi.org/10.1016/j.hrthm.2014.01.022
      Chronic oral anticoagulation (OAC) has traditionally been considered as the most effective prophylaxis against thromboembolic events in patients with atrial fibrillation (AF). However, as many as 20% of the patients with AF are not candidates for OAC.
      • Stafford R.S.
      • Singer D.E.
      Recent national pattern of warfarin use in atrial fibrillation.
      • Gottlieb L.K.I
      • Salem-Schatz S.
      • et al.
      Anticoagulation in atrial fibrillation: does efficacy in clinical trials translate into effectiveness in practice?.
      Reasons for ineligibility range from intracranial bleeding (the most serious complication) to increased propensity for mechanical injury (the least serious complication). The resumption of OAC in patients who have suffered a life-threatening complication due to OAC is associated with a much higher risk of such events in the future.

      Abbreviations:

      AF (atrial fibrillation), AP (anteroposterior), CT (computed tomography), CTA (computed tomography angiography/angiogram), LA (left atrium/atrial), LAA (left atrial appendage), LAO (left anterior oblique), OAC (oral anticoagulation), RAO (right anterior oblique), RV (right ventricle/ventricular), TEE (transesophageal echocardiography)

      Keywords

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      References

        • Stafford R.S.
        • Singer D.E.
        Recent national pattern of warfarin use in atrial fibrillation.
        Circulation. 1998; 97: 1231-1233
        • Gottlieb L.K.I
        • Salem-Schatz S.
        • et al.
        Anticoagulation in atrial fibrillation: does efficacy in clinical trials translate into effectiveness in practice?.
        Arch Intern Med. 1994; 154: 1945-1953
      1. Bartus K, Bednarek J, Myc J, Kapelak B, Sadowski J, Lelakowski J, Yakubov SJ, Lee RJ. Feasibility of closed-chest ligation of the left atrial appendage in humans. Heart Rhythm 2011;8:188–193

        • Bartus K.H.F.
        • Bednarek J.
        • Myc J.
        • Kapelak B.
        • Sadowski J.
        • Lelakowski J.
        • Bartus S.
        • Yakubov S.
        • Lee R.J.
        Percutaneous left atrial appendage suture ligation using the LARIAT in patients with atrial fibrillation: initial clinical experience.
        J Am Coll Cardiol. 2013; 62: 108-118
        • Massumi A.
        • Chelu M.G.
        • Nazeri A.
        • May S.A.
        • Afshar-Kharaghan H.
        • Saeed M.
        • Razavi M.
        • Rasekh A.
        Initial experience with a novel percutaneous left atrial appendage exclusion device in patients with atrial fibrillation, increased stroke risk, and contraindications to anticoagulation.
        Am J Cardiol. 2013; 111: 869-873