Simultaneous Transcatheter Closure of the Left Atrial Appendage and Congenital Interatrial Communication Closure

Background:Left atrial appendage closure(LAAC)with simultaneous interventional occlusion therapy for congenital interatrial communication has become a new focus of patients with nonvalvular atrial fibrillation.Little is known about the results of mid-and long-term results.Objective:The aim of this study was to evaluate the midand long-term safety and effectiveness of simultaneous transcatheter closure of the left atrial appendage(LAA)and congenital interatrial communication closure in atrial fibrillation(AF)patients.Methods:From Jan 2016 to June 2017,27 patients with AF were treated with simultaneous transcatheter closure of the LAA and atrial septal defect(ASD,n=22),patent foramen ovale(PFO,n=5).Results:The perioperative closure success rate was 96.3%,except for cardiac tamponade occurred in one ASD patient.During the median 37.6-month follow-up period,no cases of cerebrovascular or peripheral vascular embolism,bleeding,infective endocarditis or thrombosis along the occluders were observed.Of the 21 patients with NYHA Class III,nineteen had significant improvements to NYHA Classes I or II,and 81.5%of patients were free from major or minor adverse events during midand long-term follow-up.Conclusions:Simultaneous closure of the LAA and congenital interatrial communication closure is a viable option for patients with nonvalvular atrial fibrillation who are at risk of stroke or systemic embolism,and it is effective and yields excellent mid-and long-term results.