Title |
Left Atrial Appendage Exclusion for Prevention of Stroke in Atrial Fibrillation: Review of Minimally Invasive Approaches
|
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Published in |
Current Cardiology Reports, January 2014
|
DOI | 10.1007/s11886-013-0448-1 |
Pubmed ID | |
Authors |
Joshua D. Moss |
Abstract |
Stroke prevention is of vital importance in the management of atrial fibrillation (AF), though the proven strategy of systemic anticoagulation for thromboembolic prophylaxis is underutilized for a variety of reasons. The left atrial appendage (LAA) has long been suspected as the principal source of arterial emboli, particularly in nonvalvular AF, and a variety of techniques for its exclusion from the circulation have been developed. This review highlights the history of the LAA as a target of intervention, and the parallel advances in three minimally invasive strategies for its exclusion: percutaneous occlusion of the LAA orifice from within the left atrium, closed-chest ligation via a percutaneous pericardial approach, and minimally invasive thoracoscopic surgery. While further study is necessary, available evidence suggests that effective LAA exclusion is becoming a viable alternative to anticoagulation for stroke prevention in nonvalvular AF. |
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Mendeley readers
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