Progress in the study and treatment of peri-device leak after left atrial appendage closure

doi:10.12998/wjcc.v11.i25.5857

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World Journal of Clinical Cases

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World J Clin Cases. Sep 6, 2023; 11(25): 5857-5862
Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5857

Progress in the study and treatment of peri-device leak after left atrial appendage closure

Ying-Bo Qi, Hui-Min Chu

Ying-Bo Qi, Department of Cardiology, Health Science Center, Ningbo University, Ningbo 315000, Zhejiang Province, China

Hui-Min Chu, Department of Cardiology, Arrhythmia Center, Ningbo First Hospital, Ningbo 3153000, Zhejiang Province, China

Author contributions: Qi YB reviewed the literature and contributed to the manuscript drafting; Chu HM reviewed the manuscript; All authors issued approval of the final version.

Supported by Zhejiang Provincial Foundation for Medical and Health Sciences, No. 2021KY980.

Conflict-of-interest statement: All authors declare having no potential conflicts of interests for this article.

Corresponding author: Hui-Min Chu, MD, Professor, Department of Cardiology, Arrhythmia Center, Ningbo First Hospital, No. 59 Liuting Street, Ningbo 3153000, Zhejiang Province, China. epnbheart@163.com

Received: February 18, 2023
Peer-review started: February 18, 2023
First decision: May 8, 2023
Revised: May 28, 2023
Accepted: August 9, 2023
Article in press: August 9, 2023
Published online: September 6, 2023
Processing time: 194 Days and 15.8 Hours

Abstract

For patients with atrial fibrillation with an increased risk of stroke and contraindications to long-term anticoagulation, percutaneous left atrial appendage closure (LAAC) has become an important alternative to long-term oral anticoagulation. Incomplete closure of the LAAC during the procedure leads to faster blood flow in the interstitial space around the device, resulting in peri-device leak (PDL), which is not uncommon. Studies are still inconclusive in determining the incidence, long-term safety, and management of PDL. Therefore, this article reviewed the progress made in the research and treatment of PDL after LAAC.

Keywords: Atrial fibrillation; Left atrial appendage closure; Peri-device leak; Thromboembolism; Cardiac computed tomography angiography; Treatment

Core Tip: For patients with atrial fibrillation with an increased risk of stroke and contraindications to long-term anticoagulation, percutaneous left atrial appendage closure has become an important alternative to long-term oral anticoagulation. Incomplete closure of the left atrial appendage closure during the procedure leads to faster blood flow in the interstitial space around the device, resulting in peri-device leak. The incidence, long-term safety, and management of peri-device leak are still inconclusive.