Page 44 - Journal of Structural Heart Disease Volume 4, Issue 2

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Meeting Abstracts
percutaneous approach of LAA closure in each step: the passage of the delivery system through the interatrial sepum, the right position- ing of the device in LAA and the relationship with the membrane.
NO ANTIPLATELET THERAPY FOLLOWING LEFT ATRIAL APPENDAGE CLOSURE IN PATIENTS WITH VERY HIGH BLEEDING RISK
Andrea Montabone1, Giacomo Boccuzzi1, Mario Iannaccone1, Fabrizio Ugo1, Fabrizio D'ascenzo2
1 San Giovanni Bosco Hospital; San Giovanni Bosco Hospital; San Giovanni Bosco Hospital, 2 Città Della Scienza e Della Salute; Città Della Scienza e Della Salute; Città Della Scienza e Della Salute
Background: LAA percutaneous closure (LAAC) has been proposed and validated as an e ective and safe treatment in patients with atrial brillation (AF) and contra-indication to anticoagulant therapy. Optimal post procedural antithrombotic medication and its dura- tion is still under debate, as the bleeding risk needs to be balanced against the risk of device thrombus formation and thromboembolic complications. Many di erent antiplatelet regimens after LAAC have been proposed :1) 6 months DAPT + lifelong ASA, 2) 3 months DAPT + lifelong ASA, 3) 6 weeks DAPT + lifelong ASA, 4) Single ASA lifelong. Nevertheless in very high risk bleeding patients the requirement of lifelong single antiplatelet therapy remains the main limitation, as recent data showed similar bleeding rates in patients treated with ASA to those treated with oral anticoagulant. In clinical practice about 6% of patients have no antithrombotic therapy post LACC, due to high bleeding annual rates.
Objective: To investigate the long-term outcome of patients under- going LAAC followed by no antiplatelet therapy.
Methods: This is an ongoing, observational, retrospective, nonran- domized, multicenter registry. All patients treated with LAA percu- taneous occlusion with ACP/AMULET, between 2012 and 2016, that have suspended any antiplatelet therapy due to clinical conditions, will be included. At least 1 year of follow-up will be required.
Patients with no antiplatelet therapy at follow up will be compared to patients with patients who maintain either single or dual antiplatelet therapy. Additionally, the e cacy of this new antithrombotic strat- egy will be evaluated by comparing the rate of embolic and bleed- ing events at follow-up in the study population with the event rate predicted by the patients’ CHA2DS2-VASc and HAS-BLED scores, respectively.
Conclusion: Aim of this study is to prove the feasibility and safety of LAAC in a subsets of AF patients at very high bleeding risk unsuitable for lifelong sin.
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Cite this article as: Hijazi ZM. 2017 LAA CSI Focus Abstracts. Structural Heart Disease. 2018;4(2):56-65. DOI: http://dx.doi. org/10.12945/j.jshd.2018.049.17
Hijazi, Z
2017 LAA CSI Focus Abstracts