An under-recognized high-risk atrial fibrillation population: Analyzing transcatheter mitral valve repair patients for left atrial appendage closure device application.
Catheter Cardiovasc Interv
; 94(2): 274-279, 2019 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-30953408
ABSTRACT
OBJECTIVE:
Identify patients undergoing transcatheter mitral valve repair (TMVR) who could potentially benefit from alternative ischemic stroke prophylaxis utilizing a left atrial appendage closure (LAAC) device.BACKGROUND:
Patients undergoing TMVR have a high incidence of atrial fibrillation (AF). The co-morbidities which qualify them to undergo TMVR also increase their risk of stroke and bleeding, making stroke prophylaxis problematic.METHODS:
We conducted a single-center retrospective study, in which the bleeding and stroke risk of all patients undergoing TMVR for degenerative mitral valve disease were reviewed to determine candidacy for a LAAC device for stroke prevention as an alternative to chronic anticoagulation.RESULTS:
AF was present in 122 (62%) of TMVR patients with an average CHA2DS2-VASc score of 3.99. 23% of TMVR patients had a history of prior major bleeding event, predominately gastrointestinal bleed. Fifty-three and 47% of TMVR patients were at high or intermediate risk of bleeding, respectively, according to their HAS-BLED score. 50% of patients undergoing TMVR would qualify for LAAC device based on risk assessments.CONCLUSION:
Patients undergoing TMVR represent a high risk group of AF patients that may benefit from a LAAC device.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Cateterismo Cardíaco
/
Isquemia Encefálica
/
Función del Atrio Izquierdo
/
Implantación de Prótesis de Válvulas Cardíacas
/
Apéndice Atrial
/
Accidente Cerebrovascular
/
Enfermedades de las Válvulas Cardíacas
/
Válvula Mitral
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Asunto de la revista:
CARDIOLOGIA
Año:
2019
Tipo del documento:
Article