Left Atrial Appendage Closure for Stroke Prevention: Devices, Techniques, and Efficacy

Abstract

Left atrial appendage closure can be performed either surgically or percutaneously. Surgical approaches include direct suture, excision and suture, stapling, and clipping. Percutaneous approaches include endocardial, epicardial, and hybrid endocardial-epicardial techniques. Left atrial appendage anatomy is highly variable and complex; therefore, preprocedural imaging is crucial to determine device selection and sizing, which contribute to procedural success and reduction of complications. Currently, the WATCHMAN is the only device that is approved for left atrial appendage closure in the United States.

Keywords: Atrial fibrillation; Endocardial left atrial appendage closure devices; Hybrid endocardial-epicardial left atrial closure devices; Left atrial appendage closure devices; Percutaneous approach; Surgical approach.