NYMC Faculty Publications

Left Atrial Appendage Closure: What Do We Know?

Author Type(s)

Faculty

DOI

10.1097/CRD.0000000000000601

Journal Title

Cardiology in Review

First Page

153

Last Page

159

Document Type

Article

Publication Date

3-1-2025

Department

Medicine

Keywords

anticoagulation, atrial fibrillation, left atrial appendage, left atrial appendage occlusion

Disciplines

Medicine and Health Sciences

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in the United States and the most common cause of embolic cerebrovascular events, with the majority of these thrombi originating in the left atrial appendage. The left atrial appendage (LAA) has separate developmental, ultrastructural, and physiological characteristics from the left atrium. Although LAA anatomy is highly variable, it can be categorized into 4 types: cactus, cauliflower, chicken wing, and windsock. The cauliflower type is associated with higher stroke risk in patients with nonvalvular AF. Although the cornerstone of therapy to prevent embolic strokes from AF has been anticoagulation with thrombin inhibitors, a large group of patients are unable to tolerate anticoagulation due to bleeding. This has led to the development and advancement of multiple surgical and percutaneous LAA closure devices to prevent embolic cerebrovascular accidents without the need for anticoagulation. In this article, we discuss the outcomes of major studies that utilized surgical LAA occlusion and its effectiveness. Furthermore, we summarize nonsurgical methods of LAA closure and future directions regarding LAA closure.

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