Left atrial appendage closure (LAAC) in non-valvular atrial fibrillation with high risk of bleeding has shown promising results with first generation devices (with the Watchman) in the different studies. At present, we have a more modern device, the Watchman FLX, but we do not have much information about it. To gather more data, researchers looked…
TRAPEUR Registry: Thrombus Trapping with Left Atrial Appendage Closure Device
Left atrial appendage closure (LAAC) devices are a good alternative for the prevention of systemic thromboembolism in patients with non-valvular atrial fibrillation (AF) and high risk of bleeding or those with anticoagulation contraindication. According to PRAGUE-17 outcomes, at 4 years, LAAC resulted non-inferior to direct anticoagulation in the prevention of cardiovascular, neurological, and bleeding events. …
Left Atrial Appendage Closure vs Direct Anticoagulants at Long Term
The PRAGUE-17 has shown that left atrial appendage closure is not inferior to direct anticoagulants at long term to prevent major cardiovascular, neurological, or bleeding events. Moreover, procedures not related to prosthesis implantation saw significant reduction. The PRAGUE-17 was a randomized non-inferiority study comparing left atrial appendage closure (Watchman or Amulet) with direct anticoagulants (95%…
PRAGUE-17: Appendage Closure vs. Direct Anticoagulant Agents
After four years of follow-up, the PRAGUE-17 study showed that appendage closure is non-inferior to direct anticoagulant agents (non-warfarin oral anticoagulants, NOAC) to prevent major neurological events, cardiovascular events, and bleeding events in patients at high risk of atrial fibrillation. Appendage studies were compared with warfarin studies—it was necessary to update anticoagulant agents and reach…
TCT 2021 | SWISS-APERO: Difference in Leaks between the Amulet and the Watchman
The Amplatzer Amulet (Abbott) achieves better left atrial appendage closure than the Watchman 2.5 and Watchman FLX (Boston Scientific) in patients with atrial fibrillation at risk of stroke. This imaging finding has not yet been associated with clinical adverse events. This study called SWISS-APERO was presented at TCT 2021 and simultaneously published in Circulation. It…
AMULET vs. WATCHMAN: Appendage Closure Devices, Head to Head
This research was designed to compare the double closure system of the AMULET device with the WATCHMAN (an evidence-backed proven device). In that context, to prevent stroke in patients with non-valvular atrial fibrillation, the Amplatzer AMULET device was non-inferior in both safety and efficacy compared with the WATCHMAN. Atrial appendage occlusion in itself improved with…
ACC 2021 | LAAOS III: Appendage Closure During Central Vascular Surgery
According to the LAAOS III study, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in the New England Journal of Medicine (NEJM), patients with atrial fibrillation who undergo central vascular surgery for any other indication find benefit in appendage closure during said surgery. Using oral anticoagulation agents, patients undergoing appendage closure…
Net Benefit of Left Atrial Appendage Closure vs. Anticoagulation in Atrial Fibrillation
This analysis shows that the long-term clinical benefit of left atrial appendage closure with Watchman is superior to warfarin in patients with atrial fibrillation (AF). The initial peri-procedural risks of device implantation are counterbalanced over time, with reduced risk of bleeding and death. The PROTECT-AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in…
5-Year Experience of Appendage Closure: More Evidence that Does Not Translate into Clinical Practice
The use of percutaneous left appendage closure increased 3.6-fold from 2011 to 2015, but this volume increase did not entail a significant uptrend of in-hospital events in this “real-world” population in Germany. However, can Germany be considered a real-world setting for Latin America? This question is warranted by the fact that there is no apparent…
Five-Year Outcomes for Appendage Closure
The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure with the Watchman device was equivalent to warfarin for preventing stroke in atrial fibrillation, but it had a high rate of peri-procedural complications. The follow-up randomized trial was PREVAIL (Evaluation of the…
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