Left atrial appendage occlusion (LAAO) is emerging as a promising alternative to oral
anticoagulation. Because aged patients present a greater risk of not only cardioembolic
events but also major bleeding, LAAO might represent a valid alternative as this would
allow oral anticoagulation cessation while keeping cardioembolic protection. The objective
of the study was to explore the safety and efficacy of LAAO in elderly patients. Data
from the AMPLATZER Cardiac Plug multicenter registry were analyzed. The cohort was
categorized in 2 groups (<75 vs ≥75 years). A total of 1,053 subjects were included
in the registry. Of them, 219 were excluded because of combined procedures. As a result,
828 subjects were included (54.6% ≥75 years). Procedural success was high and similar
in both groups (97.3%). Acute procedural major adverse events were not statistically
different among groups (3.2% in <75 years vs 5.1%; p = 0.17) although stratified analysis
showed a higher incidence of cardiac tamponade in elderly patients (0.5% vs 2.2%;
p = 0.04). With a median follow-up of 16.8 months, no significant differences in stroke/TIA
(1.9% vs 2.3%; p = 0.89) and major bleeding (1.7% vs 2.6%; p = 0.54) were observed.
In conclusion, LAAO was associated with similar procedural success in patients aged
<75 and ≥75 years although older patients had a higher incidence of cardiac tamponade.
At follow-up, stroke and major bleeding rates were similar among groups.
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Article Info
Publication History
Published online: October 28, 2015
Accepted:
October 9,
2015
Received in revised form:
October 9,
2015
Received:
August 16,
2015
Footnotes
See page 90 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
