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Association of Peri-Procedural Major Bleeding With Outcomes in Patients Undergoing Percutaneous Left Atrial Appendage Closure

      Percutaneous left atrial appendage closure (LAAC) with the Watchman device (Boston Scientific, Marlborough, MA) is indicated for reduction of thromboembolic risk in patients with non-valvular atrial fibrillation who are poor candidates for long-term oral anticoagulation. The procedure is performed via femoral venous access using a 14 F sheath. Data from the pivotal randomized controlled trials and real-world clinical practice have shown that major bleeding in the procedural setting remains one of the most common complications of LAAC (1.5% to 3.5%).
      • Reddy VY
      • Doshi SK
      • Kar S
      • Gibson DN
      • Price MJ
      • Huber K
      • Horton RP
      • Buchbinder M
      • Neuzil P
      • Gordon NT
      • Holmes DR
      PREVAIL and PROTECT AF investigators. 5-year outcomes after left atrial appendage closure: from the PREVAIL and PROTECT AF trials.
      ,
      • Freeman JV
      • Varosy P
      • Price MJ
      • Slotwiner D
      • Kusumoto FM
      • Rammohan C
      • Kavinsky CJ
      • Turi ZG
      • Akar J
      • Koutras C
      • Curtis JP
      • Masoudi FA.
      The NCDR left atrial appendage occlusion registry.
      To date, scarce data exist on the impact of major bleeding on outcomes after LAAC. Therefore, we aimed to investigate the association of major bleeding following LAAC on outcomes using a contemporary nationwide database.
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      References

        • Reddy VY
        • Doshi SK
        • Kar S
        • Gibson DN
        • Price MJ
        • Huber K
        • Horton RP
        • Buchbinder M
        • Neuzil P
        • Gordon NT
        • Holmes DR
        PREVAIL and PROTECT AF investigators. 5-year outcomes after left atrial appendage closure: from the PREVAIL and PROTECT AF trials.
        J Am Coll Cardiol. 2017; 70: 2964-2975
        • Freeman JV
        • Varosy P
        • Price MJ
        • Slotwiner D
        • Kusumoto FM
        • Rammohan C
        • Kavinsky CJ
        • Turi ZG
        • Akar J
        • Koutras C
        • Curtis JP
        • Masoudi FA.
        The NCDR left atrial appendage occlusion registry.
        J Am Coll Cardiol. 2020; 75: 1503-1518
      1. Anon. NRD Overview. Available at: https://www.hcup-us.ahrq.gov/nrdoverview.jsp. Accessed March 20, 2021.

        • Price MJ
        • Reddy VY
        • Valderrábano M
        • Halperin JL
        • Gibson DN
        • Gordon N
        • Huber KC
        • Holmes DR.
        Bleeding outcomes after left atrial appendage closure compared with long-term warfarin: a pooled, patient-level analysis of the WATCHMAN randomized trial experience.
        JACC Cardiovasc Interv. 2015; 8: 1925-1932
        • Nombela-Franco L
        • Rodés-Cabau J
        • Cruz-Gonzalez I
        • Freixa X
        • Asmarats L
        • Gutiérrez H
        • Sahay S
        • Rodriguez-Gabella T
        • Moreno-Samos JC
        • Tirado-Conte G
        • Goncalves-Ramirez LR
        • Rama-Merchan JC
        • Amat-Santos IJ
        • O'Hara G
        • Martín-Yuste V
        • Bethencourt A
        • Jimenez-Quevedo P
        • Macaya C
        Incidence, predictors, and prognostic value of acute kidney injury among patients undergoing left atrial appendage closure.
        JACC Cardiovasc Interv. 2018; 11: 1074-1083