Left Atrial Appendage Closure

1. Front Matter

   Pages i-xi

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2. Rationale for LAA Closure

   1. Front Matter

      Pages 1-1

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   2. Atrial Fibrillation and Stroke Epidemiology

      • Karen P. Phillips

      Pages 3-16

   3. Efficacy and Limitations of Warfarin and Novel Oral Anticoagulants with Atrial Fibrillation

      • John A. Cairns

      Pages 17-36

   4. Mechanistic Rationale for LAA Closure with AF and Stroke Prevention

      • David Meerkin

      Pages 37-44

   5. LAA Anatomy

      • Creighton W. Don, Andrew C. Cook, Mark Reisman

      Pages 45-57

3. Surgical Approaches for LAA Closure

   1. Front Matter

      Pages 59-59

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   2. Conventional Surgery for LAA Closure

      • Hasib Hanif, Richard Whitlock

      Pages 61-80

4. Imaging for LAA Closure

   1. Front Matter

      Pages 81-81

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   2. The Use of Transesophageal Echocardiography to Guide Percutaneous LAA Closure

      • Julie A. Humphries

      Pages 83-100

   3. The Use of Intracardiac Echocardiography (ICE) to Guide LAA Closure

      • Sergio Berti, Umberto Paradossi, Gennaro Santoro

      Pages 101-115

   4. CT Imaging for Percutaneous LAA Closure

      • Jacqueline Saw, Joao Pedro Lopes, Mark Reisman, Hiram G. Bezerra

      Pages 117-132

5. Percutaneous LAA Closure Devices and Trial Results

   1. Front Matter

      Pages 133-133

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   2. PLAATO Device

      • Randall J. Lee

      Pages 135-142

   3. WATCHMAN Device

      • Karen P. Phillips, Saibal Kar

      Pages 143-168

   4. WATCHMAN: Trials and Registries Results

      • Jacqueline Saw, Saibal Kar, Matthew J. Price

      Pages 169-180

   5. Amplatzer Cardiac Plug and Amulet

      • Jacqueline Saw

      Pages 181-193

   6. ACP and Amulet: Trials and Registries Results

      • Xavier Freixa, Apostolos Tzikas, Réda Ibrahim

      Pages 195-203

   7. LARIAT: The Endo-Epicardial Technique for Left Atrial Appendage Exclusion

      • Arun Kanmanthareddy, Sampath Gunda, Nitish Badhwar, Randall J. Lee, Dhanunjaya Lakkireddy

      Pages 205-223

   8. LARIAT: Trials and Registries Results

      • Miguel Valderrábano

      Pages 225-232

Percutaneous left atrial appendage (LAA) closure is an emerging technology for thromboembolic prevention in patients with atrial fibrillation (AF). The first human implantation of an LAA device occurred in 2001, and since then four devices have received CE mark approval. These devices are being widely used in Europe for LAA closure in patients who are poor candidates for long-term oral anticoagulation. In the US, the WATCHMAN device (Boston Scientific) is anticipated to receive FDA approval imminently for AF patients who are warfarin-eligible. This approval is projected to significantly expand the indications for LAA closures worldwide. Thus, the volume of procedures is anticipated to escalate. This book discusses the epidemiology of AF as a cause of stroke; the use of LAA closure in the reduction of thromboembolism with AF; early surgical approaches and novel surgical devices for LAA closure; and current percutaneous approaches and devices available for LAA closure. The emphasis of this book is on percutaneous technical approaches and contemporary trial results on the leading devices (PLAATO, WATCHMAN, Amplatzer Cardiac Plug, and LARIAT). It also reviews unapproved devices in development, in both clinical and pre-clinical phases.

• Amplatzer Cardiac Plug
• LARIAT device
• WATCHMAN device
• atrial fibrillation
• left atrial appendage closure
• thromboembolic prevention

• Vancouver General Hospital, University of British Columbia, Vancouver, Canada

  Jacqueline Saw

• Cardiovascular Intervention Center Research, Cedars-Sinai Medical Center, Los Angeles, USA

  Saibal Kar

• Scripps Translational Science Institute, Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, USA

  Matthew J. Price

Jacqueline Saw, MD, FRCPC, FACC, FSCAI Clinical Associate Professor University of British Columbia Head, VGH Cardiology Clinical Trials Research Program Director, VGH Interventional Cardiology Fellowship Vancouver General Hospital 2775 Laurel Street, Level 9 Vancouver, V5Z1M9, British Columbia Canada Saibal Kar, MD, FACC Director, Interventional Cardiology Research Cedars-Sinai Medical Center 8631 W. 3rd Street, #415E Los Angeles, CA 90048 Matthew J. Price, MD, FACC, FSCAI Director, Cardiac Catheterization Laboratory Division of Cardiovascular Diseases Scripps Clinic Assistant Professor Scripps Translational Science Institute 10666 North Torrey Pines Road, Maildrop S1056 La Jolla, CA 92037 Jacqueline Saw is the editor of Carotid Artery Stenting: The Basics (978-1-60327-313-8, 2009) and Handbook of Complex Percutaneous Carotid Intervention (978-1-58829-605-4, 2007), both of which are volumes in the Contemporary Cardiology series.

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