Authors

• Vedran Pašara — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-6587-2315
• Ivan Prepolec — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0001-5870-202X
• Borka Pezo-Nikolić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-0504-5238
• Vlatka Rešković Lukšić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-4721-3236
• Sandra Jakšić Jurinjak — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0002-7349-6137
• Davor Puljević — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0003-3603-2242
• Davor Miličić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0001-9101-1570
• Vedran Velagić — University of Zagreb School of Medicine, Zagreb, Croatia — ORCID: 0000-0001-5425-5840

Keywords

left atrial appendage, atrial fibrillation, stroke

DOI

Full Text

**Introduction**: Transcatheter left atrial appendage occlusion (LAAO) is a stroke prevention method for patients with atrial fibrillation (AF) and increased thromboembolic risk with a contraindication for oral anticoagulation (OAC) or with an elevated bleeding risk under chronic OAC. (1) This study aimed to assess patient characteristics, acute success rate, and periprocedural complication rate of transcatheter LAAO procedures in our institution. **Patients and Methods**: This single-center retrospective observational study included all patients who underwent transcatheter LAAO in our center from June 2021 until October 2022. Data were collected from hospital electronic medical records. **Results**: We evaluated all 18 consecutive patients (55.6% male, 72.2 ± 6.3 years) who underwent transcatheter LAAO. Patient characteristics and risk factors are shown in **Table 1**. The acute success rate was 88.9%, two proctored procedures were unsuccessful due to unfavorable anatomy. There were no procedure-related stroke, device embolization, or device-related thrombus. Procedure characteristics are shown in **Table 2**. Three patients (16.7%) developed postprocedural groin hematoma. One patient developed a femoral arteriovenous fistula and required surgical repair, while another patient developed hemodynamically irrelevant pericardial effusion. During follow-up, there were no thromboembolic complications, and one patient had a bleeding complication with dual antiplatelet therapy. ### TABLE 1: Patient characteristics and risk factors. | Male, N (%) | 10 (55.6) | | --- | --- | | Age, years | 72.2 ± 6.3 | | BMI, kg/m2 | 27.5 ± 4.1 | | LVEF, % | 53.9 ± 9.1 | | Persistent/permanent AF, N (%) | 9 (50) | | Prior TIA/stroke, N (%) | 4 (22.2) | | Prior major bleeding, N (%) | 14 (77.8) | | CHADSVASc | 3.5 ± 1.5 | | HASBLED | 3.0 ± 0,.5 | ### TABLE 2: Procedure characteristics. | Procedure time, min | 75.8 ± 27.6 | | --- | --- | | Fluoroscopy time, min | 9.3 ± 4.5 | | Radiation dose, mGy | 529.4 ± 472.3 | | Dose area product, mcGy/m2 | 4542.4 ± 4132.1 | | Contrast agent, ml | 61.4 ± 29.5 | **Conclusion**: Our data suggest that, since the introduction of this technology, transcatheter LAAO can be performed in our center with a good rate of acute success and low risk of periprocedural adverse events.

Literature

1. Glikson M, Wolff R, Hindricks G, Mandrola J, Camm AJ, Lip GYH, et al. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion - an update. Europace. 2020 February 1;22(2):184. https://doi.org/10.1093/europace/euz258