Left atrial appendage (LAA) transcatheter occlusion is a recent alternative for the prevention of thromboembolism in patients with Not Valvular Atrial Fibrillation (NVAF). Different imaging techniques have been used for establishing LAA complete occlusion and the TransEsophageal Echocardiography (TEE) is still the most common tool used. Neverthless very limited data are available about mid to long term outcome in patients who underwent this procedure. The aim of our study was to verify if advanced cardiac imaging including Cardiac Computed Tomography Angiography (CCTA) and TEE are...

We evaluated 71 patients with NVAF and controindications to anticoagulant (mean age 77±6 ys; male 56%; mean CHA2DS2-VASc score 4.4 ± 1.3; HAS- BLED score 3.4 ±1.0) who underwent LAA transcatheter occlusion procedure using the Amplatzer© Cardiac Plug (ACP, Aga Medical, Plymouth,MN) between January 2009 and July 2013. All patients were cronically treated with a single antiplatelet agent after a short period of dual antiplatelet drugs. FU was performed with phone intervews and/or outpatient visits. All patients where evaluated with CCTA (Toshiba Aquilion 64 and...

At a mean 15±12 months follow-up period (90,9 patient years) we evaluated 71 patients with CCTA. Proper ACP apposition was confirmed but a residual LAA flow or peri-device leak was identified in 52 patients (discovered during arterial phase in 27 patients and during venous phase in 25 patients) (Fig.1; Tab.1). We observed a residual flow and round thrombus inside the LAA in 1 case and a residual flow with thrombus adherent to the atrial side of the ACP disk in 2 cases (Fig.2) as collateral...

Our data suggest thatresidual peri-device flow into the LAA after percutaneous closure withAmplatzer Cardiac Plugis not associated with a higher incidence of clinical cerebrovascular events according to previous findings [1,2]. CCTA identifies a higher number of peri-device leak than TEE. TEE is still the most used tool but can represent the technique of choice only in a subgroup of patients with absolute contraindications to intravenous adminastration of iodinated contrast agent.

1)Incomplete occlusion of the left atrial appendage with the percutaneous left atrial appendage transcatheter occlusion device is not associated with increased risk of stroke. J. F. Viles-Gonzalez et al. J Interv Card Electrophysiol (2012) 33:69–75 2) The Clinical Impact of Incomplete Left Atrial Appendage Closure With the Watchman Device in Patients With Atrial Fibrillation: A PROTECT AF (Prevention Of Stroke in Patients With Atrial Fibrillation) Substudy (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin) J.F. Viles Gonzales J Am Coll Cardiol, 2012; 59:923-929