RT Book, Section
A1 Fahmy, Peter
A1 Saw, Jacqueline
A2 Baliga, R. R.
A2 Lilly, Scott M.
A2 Abraham, William T.
SR Print(0)
ID 1160207592
T1 Left Atrial Appendage Closure
T2 Color Atlas and Synopsis of Interventional Cardiology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071749350
LK accesscardiology.mhmedical.com/content.aspx?aid=1160207592
RD 2024/04/19
AB An  84  year-old  woman  with  hypertension,  chronic  obstructive  pulmonary  disease,  and  chronic  renal  insufficiency  (estimated  glomerular  filtration,  rate  38  mL/min/1.73  m2)  also  has  paroxysmal  atrial  fibrillation  (AF)  with  a  CHADS2  score  of  4  and  CHA2DS2-VASc  score  of  6.  She  suffered  a  stroke  a  year  ago  and  was  treated  with  tissue  plasminogen  activator.  This  was  complicated  by  hemorrhagic  transformation,  resulting  in  expressive  dysphagia.  Given  her  history  of  intracranial  hemorrhage,  she  was  deemed  to  be  a  poor  candidate  for  long-term  oral  anticoagulation  (OAC)  and  was  thus  referred  for  endovascular  left  atrial  appendage  (LAA)  closure.  Under  general  anesthesia  and  transesophageal  echocardiography  (TEE)  guidance,  a  28-mm  Amplatzer  Cardiac  Plug  (ACP;  St.  Jude  Medical,  St.  Paul,  MN)  was  successfully  deployed.  The  patient  was  discharged  the  following  day  with  no  complication  and  was  commenced  on  dual  antiplatelet  therapy  (aspirin  81  mg/d  and  clopidogrel  75  mg/d)  for  3  months,  followed  by  aspirin  indefinitely.