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Why Follow-up Examinations After Left Atrial Appendage Closure Are Important: Detection of Complications During Follow-up and How to Deal with Them

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
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Abstract

Purpose of Review

Device-related thrombus (DRT) formation and incomplete left atrial appendage closure (LAAC) are the two major complications that can occur after LAAC and can potentially limit the success of such a procedure. This review discusses the incidence, clinical and/or prognostic significance, detection methods, treatment options, and potential strategies to prevent these complications.

Recent Findings

It has recently been proven that the presence of a DRT represents an independent predictor for ischemic stroke after LAAC. Continued need for anticoagulation due to incomplete LAAC is clinically relevant to the patient.

Summary

The appearances of a DRT or an incompletely closed LAA after a LAAC procedure are not rare complications. Due to the clinical and/or prognostic significance of these complications, it is important to detect them in a timely manner during follow-up by using the appropriate diagnostic imaging techniques. Since a DRT is associated with an increased risk of stroke, the therapy should be aggressive. In the case of incomplete LAA closure, an additional closure device may be used to complete occlusion and avoid lifelong anticoagulation therapy.

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Authors and Affiliations

  1. Cardiovascular Center Darmstadt, Dieburgerstrasse 31c, 64287, Darmstadt, Germany

    Nina C. Wunderlich, Gabriele C. Lorch, Jörg Honold & Harald Küx

  2. Division of Cardiology, Department of Internal Medicine III, Goethe University Frankfurt, Frankfurt, Germany

    Jörg Honold

  3. Department of Cardiology, University of Heidelberg, Heidelberg, Germany

    Jennifer Franke

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  1. Nina C. Wunderlich
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Correspondence to Nina C. Wunderlich.

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Nina C. Wunderlich reports speaker honoraria from Abbott Vascular, Philips Healthcare, and Lifetech. Gabriele Lorch, Jennifer C. Franke, and Harald Küx declare no conflicts of interest.

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Wunderlich, N.C., Lorch, G.C., Honold, J. et al. Why Follow-up Examinations After Left Atrial Appendage Closure Are Important: Detection of Complications During Follow-up and How to Deal with Them. Curr Cardiol Rep 22, 113 (2020). https://doi.org/10.1007/s11886-020-01357-3

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