Percutaneous left atrial appendage closure in patients with primary hemostasis disorders and atrial fibrillation

ConclusionsPercutaneous LAAC in primary HD carriers appeared as safe and as effective as in overall LAAC population for stroke and bleeding prevention at midterm follow-up.Graphical abstractPercutaneous left atrial appendage closure in patients with atrial fibrillation and primary hemostasis disorders. The percutaneous LAAC in primary hemostasis disorders and AF carriers requires a multidisciplinary approach. Cardiologist, anesthesiologist, and hematologist discussion is a cornerstone to assess anticoagulant contraindication, LAAC feasibility, periprocedural management, and follow-up(high). This multidisciplinary care is illustrated by the case of a 61-year-old male with hemophilia type A and recurrent hemarthrosis. Pre-LAAC assessment confirmed procedural indication and cactus LAA anatomy(left). After plasmatic management with factor VIII infusion, a WATCHMAN ™ no. 21 was successfully implanted(middle). During follow-up, without antithrombotic regime, no ischemic or hemorrhagic complication occurred(right). LAA, left atrial appendage; LAAC, left atrial appendage closure; TEE, transesophageal echocardiography.  Percutaneous LAAC in primary HD carriers appeared as safe and as effective as in overall LAAC population for stroke and bleeding prevention at midterm follow-up.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research