A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device

Marian Burysz; Michalina Malec-Litwinowicz; Jakub Batko; Radoslaw Litwinowicz; Mariusz Kowalewski; Bogusław Kapelak; Krzysztof Bartus

doi:10.5114/kitp.2023.134176

eISSN: 1897-4252
ISSN: 1731-5530

Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery

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abstract:

Original paper

A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device

Marian Burysz

¹

,

Michalina Malec-Litwinowicz

²

,

Jakub Batko

^{3, 4}

,

Radoslaw Litwinowicz

^{1, 3, 4}

,

Mariusz Kowalewski

^{4, 5, 6}

,

Bogusław Kapelak

⁷

,

Krzysztof Bartus

⁷

Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland
Department of Neurology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
CAROL – Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland

Kardiochirurgia i Torakochirurgia Polska 2023; 20 (4): 215-219

DOI: https://doi.org/10.5114/kitp.2023.134176

Online publish date: 2024/01/11

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AMA

Burysz M, Malec-Litwinowicz M, Batko J, et al. A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(4):215-219. doi:10.5114/kitp.2023.134176.

APA

Burysz, M., Malec-Litwinowicz, M., Batko, J., Litwinowicz, R., Kowalewski, M.,  & Kapelak, B. et al. (2023). A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(4), 215-219. https://doi.org/10.5114/kitp.2023.134176

Chicago

Burysz, Marian, Michalina Malec-Litwinowicz, Jakub Batko, Radoslaw Litwinowicz, Mariusz Kowalewski, Bogusław Kapelak,  and Krzysztof Bartus. 2023. "A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 20 (4): 215-219. doi:10.5114/kitp.2023.134176.

Harvard

Burysz, M., Malec-Litwinowicz, M., Batko, J., Litwinowicz, R., Kowalewski, M., Kapelak, B.,  and Bartus, K. (2023). A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(4), pp.215-219. https://doi.org/10.5114/kitp.2023.134176

MLA

Burysz, Marian et al. "A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 20, no. 4, 2023, pp. 215-219. doi:10.5114/kitp.2023.134176.

Vancouver

Burysz M, Malec-Litwinowicz M, Batko J, Litwinowicz R, Kowalewski M, Kapelak B et al. A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(4):215-219. doi:10.5114/kitp.2023.134176.

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Introduction
Over the past decade, left atrial appendage occlusion (LAAO) has emerged as an established alternative to oral anticoagulation for patients diagnosed with atrial fibrillation (AF). The LARIAT device stands as the sole available epicardial system for complete percutaneous left atrial appendage (LAA) closure.

Aim
To present the extended outcomes (spanning over 9 years of observation) in patients with AF who underwent epicardial LAAO. The presented results constitute the longest observation in world literature.

Material and methods
A prospective, single-center study was conducted on 121 patients undergoing LAAO with the LARIAT system. Incidence of thromboembolic events and severe bleeding and mortality rates were documented. The reduction in the risk of thromboembolism and bleeding after LAAO was quantified.

Results
The mean follow-up duration was 74.18 months. The average CHADS2 score was 1.9 ±1.0, CHA2DS2-VAS score was 2.8 ±1.5, and HAS-BLED score was 2.7 ±1.0. The mean annual thromboembolic event rate was 0.7%, resulting in a 75% reduction in estimated thromboembolic risk. The annual occurrence of major bleeding complications was 0.8%, leading to a 67.9% reduction in estimated bleeding risk. The overall annual mortality rate was 1.2%.

Conclusions
Epicardial LAAO employing the LARIAT device yields commendable long-term outcomes by reducing stroke and bleeding risk.

keywords:

A decade later: long-term results of the first percutaneous epicardial closure of the left atrial appendage using the LARIAT device

Marian Burysz 1 , Michalina Malec-Litwinowicz 2 , Jakub Batko 3, 4 , Radoslaw Litwinowicz 1, 3, 4 , Mariusz Kowalewski 4, 5, 6 , Bogusław Kapelak 7 , Krzysztof Bartus 7

atrial fibrillation, left atrial appendage occlusion, LARIAT, atrial fibrillation, stroke

Marian Burysz

¹

,

Michalina Malec-Litwinowicz

²

,

Jakub Batko

^{3, 4}

,

Radoslaw Litwinowicz

^{1, 3, 4}

,

Mariusz Kowalewski

^{4, 5, 6}

,

Bogusław Kapelak

⁷

,

Krzysztof Bartus

⁷