Title Kairiojo prieširdžio ausytės uždariklis, kaip alternatyva esant prieširdžių virpėjimui ir kontraindikacijoms naudoti antikoaguliantus /
Translation of Title Left atrial appendage closure as an alternative option when anticoagulants are contraindicated in patients with atrial fibrillation.
Authors Kiseliūtė, Margarita
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Pages 41
Abstract [eng] Atrial fibrillation is the most common arrhythmia in the world associated with an increased risk of thromboembolic events and requiring constant use of anticoagulants. Although in some cases when bleeding risk is increased due to different health conditions anticoagulants might be contraindicated. An alternative option for these patients is left atrial appendage occlusion. Objective. To analyze the use of left atrial appendage occlusion device in patients with nonvalvular atrial fibrillation and contraindications for anticoagulants in the context of a clinical case and scientific literature. Material and methods. Clinical case analysis and a review of scientific literature were made. Articles were selected from PubMed and Google Scholar databases using below-mentioned keywords. In this review 33 full-text articles written in English were used. Clinical case. A 63-year-old woman with atrial fibrillation was diagnosed with aneurysms of carotid arteries. According to the recommendations of specialists the use of Apixaban was discontinued and left atrial appendage occlusion was planned. The procedure was accomplished successfully and no complications occurred. Discussion. In patients with nonvalvular atrial fibrillation around 90% of thrombi are located in the left atrial appendage. Hence mechanical isolation of this anatomical structure is being used to reduce the risk of thromboembolic events. Results of studies comparing the efficacy and safety of oral anticoagulants and left atrial appendage occlusion showed that this procedure is non-inferior to the use of oral anticoagulants. It has been found that left atrial appendage occlusion had a lower incidence of bleeding compared to oral anticoagulation therapy and increasing operators’ experience was associated with a reduction in rates of early procedure-related complications. Conclusions. Left atrial appendage occlusion significantly reduces the rates of thromboembolic events and is non-inferior to oral anticoagulant therapy. Although further investigation is needed to evaluate the use of these devices in patients with absolute contraindications for oral anticoagulants.
Dissertation Institution Vilniaus universitetas.
Type Master thesis
Language Lithuanian
Publication date 2023