Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 4)
Left atrial appendage closure with Watchman device in prevention of thromboembolic complications in patients with atrial fibrillation: First experience in Serbia
Authors:
Milan A. Nedeljković, Branko Beleslin, Milorad Tešić, Bosiljka Vujisić Tešić, Vladan Vukčević, Goran Stanković, Siniša Stojković, Dejan Orlić, Tatjana Potpara, Nebojša Mujović, Milan Marinković, Olga Petrović, Marek Grygier, Alexey V. Protopopov, Vladimir
Introduction. Atrial fibrillation (AF) is the major cause ofstroke, particularly in older patients over 75 years of age.
European Society of Cardiology guidelines recommend
chronic anticoagulation therapy in patients with atrial fibrillation
if CHA2DS2-VASc score is ≥ 1 [CHA2DS2-VASc score
for estimating the risk of stroke in patients with nonrheumatic
AF consisting of the first letters of patients condition:
C – congestive heart failure; H – hypertension; A2 –
age ≥ 75 years; D – diabetes mellitus; S2 – prior stroke,
transitory ischaemic attack (TIA) or thrombolism; V – vascular
disease; A – age 65–74 years; Sc – sex category].
However, a significant number of patients have a high bleeding
risk, or are contraindicated for chronic oral anticoagulation,
and present a group of patients in whom alternative
treatment options for thromboembolic prevention are
required. Transcatheter percutaneous left atrial appendage
closure (LAAC) devices have been recommended in patients
with contraindications for chronic anticoagulant
therapy. Case report. We present our first three patients
with nonvalvular AF and contraindications for chronic anticoagulant
therapy who were successfully treated with implantation
of LAAC Watchman device in Catheterization
Laboratory of the Clinic for Cardiology, Clinical Center of
Serbia in Belgrade Conclusion. Our initial results with
Watchman LAAC device are promising and encouraging,
providing real alternative in patients with non-valvular AF
and contraindication for chronic anticoagulant therapy and
high bleeding risk.
