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Maurina et al. Mini-invasive Surg 2021;5:53 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.88

Review Open Access

Left atrial appendage occlusion in patients with

atrial fibrillation: focus on current evidence and
commercially available devices

1,2
1,2
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Matteo Maurina 1,2,# , Alessandro Villaschi 1,2,# , Carlo Andrea Pivato , Antonio Mangieri , Mauro Chiarito ,
2
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2
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Letizia Bertoldi , Martina Briani , Fabio Fazzari , Bernhard Reimers , Damiano Regazzoli , Paolo Pagnotta 2
1
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy.
2
IRCCS Humanitas Research Hospital, Rozzano 20089, Milan, Italy.
#
Authors contributed equally and considered joint first authors.
Correspondence to: Dr. Damiano Regazzoli, Cardio Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano
20089, Milan, Italy. E-mail: damiano.regazzolilancini@humanitas.it
How to cite this article: Maurina M, Villaschi A, Pivato CA, Mangieri A, Chiarito M, Bertoldi L, Briani M, Fazzari F, Reimers B,
Regazzoli D, Pagnotta P. Left atrial appendage occlusion in patients with atrial fibrillation: focus on current evidence and
commercially available devices. Mini-invasive Surg 2021;5:53. https://dx.doi.org/10.20517/2574-1225.2021.88
Received: 18 Jul 2021 First Decision: 7 Sep 2021 Revised: 27 Sep 2021 Accepted: 8 Oct 2021 Published: 5 Nov 2021
Academic Editors: Andrea Scotti, Giulio Belli Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Atrial fibrillation is the most common cardiac arrhythmia and is associated with morbidity and mortality due to
cerebral or systemic embolization, with cardiac thrombi mainly forming in the left atrial appendage (LAA).
Anticoagulation is the treatment of choice; however, in patients who do not tolerate anticoagulation, LAA occlusion
(LAAO) is a valid alternative. Over the last decade, many different LAAO devices have been developed and tested
in trials, providing good clinical results. The purpose of this paper is to make an overview of the current state of the
art of LAAO procedure, with a focus on available devices and future perspectives.

Keywords: Left atrial appendage, left atrial appendage occlusion, atrial fibrillation, stroke prevention

INTRODUCTION
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with cerebral or systemic
embolization as a result of possible thrombus formation in the left atrium and left atrial appendage
(LAA) . In addition, AF is associated with increased mortality .
[2]
[1]

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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