Combined transcatheter aortic valve replacement and left atrial appendage occlusion in patients ineligible for oral anticoagulation: A case series

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFREIRE, A. F. D.
dc.contributor.authorFILIPPINI, F. B.
dc.contributor.authorBIGNOTO, T. C.
dc.contributor.authorBRITO, P. H. F. de
dc.contributor.authorNICZ, P. F. G.
dc.contributor.authorMELO, P. H. M. C. D.
dc.contributor.authorSILVA, R. C. e
dc.contributor.authorQUEIROGA, M.
dc.contributor.authorRIBEIRO, H. B.
dc.contributor.authorPROCóPIO, A. G. M.
dc.contributor.authorBEZERRA, C. G.
dc.contributor.authorGRUBE, E.
dc.contributor.authorABIZAID, A.
dc.contributor.authorFILHO, R. K.
dc.contributor.authorBRITO JR., F. S. de
dc.date.accessioned2024-03-13T20:05:24Z
dc.date.available2024-03-13T20:05:24Z
dc.date.issued2022
dc.description.abstractPatients presenting with aortic stenosis and atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR) are commonly at increased risk for stroke and bleeding complications. Concomitant left atrial appendage occlusion (LAAO) after TAVR may be an alternative to oral anticoagulation (OAC). Between 2018 and 2022, 7 consecutive patients who were ineligible for OAC underwent simultaneous TAVR and LAAO. The mean age was 84.9 ± 4.9 years. The mean CHA2DS2-VASc, HAS-BLED, and STS predicted risk of mortality scores were 5.9 ± 0.7, 3.9 ± 1.1, and 8.8 ± 3.4%, respectively. The median follow-up time was 23 (1 to 27) months. All procedures achieved technical success and no adverse events were observed during follow-up. This case series shows that concomitant TAVR and LAAO is feasible and safe among patients with severe aortic stenosis and AF who are deemed ineligible for OAC. Learning objectives: Atrial fibrillation is the most common arrhythmia in the transcatheter aortic valve replacement (TAVR) population. In those who experience major or life-threatening bleeding, mortality is doubled. We report a case series of 7 concomitant left atrial appendage occlusions (LAAO) after TAVR in patients ineligible for oral anticoagulation. All procedures achieved technical success and no adverse events were observed. The simultaneous approach with TAVR and LAAO was feasible and safe in this case series.eng
dc.description.indexPubMed
dc.description.indexScopus
dc.description.indexDimensions
dc.identifier.citationJOURNAL OF CARDIOLOGY CASES, v.26, n.3, p.181-185, 2022
dc.identifier.doi10.1016/j.jccase.2022.04.008
dc.identifier.issn1878-5409
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58713
dc.language.isoeng
dc.publisherELSEVIER LTDeng
dc.relation.ispartofJournal of Cardiology Cases
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER LTDeng
dc.subjectAnticoagulationeng
dc.subjectAntiplateleteng
dc.subjectAortic valveeng
dc.subjectAtrial fibrillationeng
dc.subjectStenosiseng
dc.subjectThrombuseng
dc.subjectValve replacementeng
dc.subject.otheracetylsalicylic acideng
dc.subject.otheranticoagulant agenteng
dc.subject.otherclopidogreleng
dc.subject.otherabsence of complicationseng
dc.subject.otheragedeng
dc.subject.otheranticoagulant therapyeng
dc.subject.otheraortic stenosiseng
dc.subject.otherargon plasma coagulationeng
dc.subject.otherarticleeng
dc.subject.otheratrial fibrillationeng
dc.subject.otherbicuspid aortic valveeng
dc.subject.otherbrain hemorrhageeng
dc.subject.othercase reporteng
dc.subject.othercase studyeng
dc.subject.othercha2ds2-vasc scoreeng
dc.subject.otherclinical articleeng
dc.subject.othercomputer assisted tomographyeng
dc.subject.otherconservative treatmenteng
dc.subject.otherdrug contraindicationeng
dc.subject.otherdual antiplatelet therapyeng
dc.subject.otherfaintnesseng
dc.subject.otherfall riskeng
dc.subject.otherfeasibility studyeng
dc.subject.otherfemaleeng
dc.subject.otherfollow upeng
dc.subject.otherfrailtyeng
dc.subject.otherfunctional diseaseeng
dc.subject.othergastrointestinal hemorrhageeng
dc.subject.otherhas bled scoreeng
dc.subject.otherheart failureeng
dc.subject.otherheart left atriumeng
dc.subject.otherheart left ventricle ejection fractioneng
dc.subject.otherheart left ventricle failureeng
dc.subject.otherhigh risk patienteng
dc.subject.otherhumaneng
dc.subject.otherleft atrial appendage closureeng
dc.subject.othermaleeng
dc.subject.othermonotherapyeng
dc.subject.othermortality riskeng
dc.subject.othernew york heart association classeng
dc.subject.otherpatient safetyeng
dc.subject.otherrandomized controlled trial (topic)eng
dc.subject.otherrectum hemorrhageeng
dc.subject.othersociety of thoracic surgeons scoreeng
dc.subject.othersubdural hematomaeng
dc.subject.othertranscatheter aortic valve implantationeng
dc.subject.othertransesophageal echocardiographyeng
dc.subject.othervery elderlyeng
dc.titleCombined transcatheter aortic valve replacement and left atrial appendage occlusion in patients ineligible for oral anticoagulation: A case serieseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalBRITO, P. H. F. de:Hospital Sírio-Libanês, São Paulo, Brazil
hcfmusp.author.externalMELO, P. H. M. C. D.:Hospital Sírio-Libanês, São Paulo, Brazil, Hospital São Camilo, São Paulo, Brazil
hcfmusp.author.externalSILVA, R. C. e:Hospital Sírio-Libanês, São Paulo, Brazil, Hospital São Camilo, São Paulo, Brazil
hcfmusp.author.externalQUEIROGA, M.:Hospital Nossa Senhora das Neves, João Pessoa, Brazil
hcfmusp.author.externalPROCóPIO, A. G. M.:Hospital Unimed Recife, Recife, Brazil
hcfmusp.author.externalBEZERRA, C. G.:Hospital Aliança, Salvador, Brazil
hcfmusp.author.externalGRUBE, E.:The Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
hcfmusp.author.externalABIZAID, A.:The Heart Institute, University of São Paulo Medical School, São Paulo, Brazil, Hospital Sírio-Libanês, São Paulo, Brazil
hcfmusp.author.externalFILHO, R. K.:The Heart Institute, University of São Paulo Medical School, São Paulo, Brazil, Hospital Sírio-Libanês, São Paulo, Brazil
hcfmusp.author.externalBRITO JR., F. S. de:The Heart Institute, University of São Paulo Medical School, São Paulo, Brazil, Hospital Sírio-Libanês, São Paulo, Brazil
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcANTONIO FERNANDO DINIZ FREIRE
hcfmusp.contributor.author-fmusphcFILIPPE BARCELLOS FILIPPINI
hcfmusp.contributor.author-fmusphcTIAGO COSTA BIGNOTO
hcfmusp.contributor.author-fmusphcPEDRO FELIPE GOMES NICZ
hcfmusp.contributor.author-fmusphcHENRIQUE BARBOSA RIBEIRO
hcfmusp.description.beginpage181
hcfmusp.description.endpage185
hcfmusp.description.issue3
hcfmusp.description.volume26
hcfmusp.origemSCOPUS
hcfmusp.origem.dimensionspub.1148149265
hcfmusp.origem.scopus2-s2.0-85130795579
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hcfmusp.relation.referenceReddy V.Y., Mobius-Winkler S., Miller M.A., Neuzil P., Schuler G., Wiebe J., Et al., Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology), J Am Coll Cardiol, 61, pp. 2551-2556, (2013)eng
hcfmusp.scopus.lastupdate2024-05-17
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