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Application and Classification of Left Atrial Appendage Occluder

Application and Classification of Left Atrial Appendage Occluder

1. Left atrial appendage occluder used in occlusion

Atrial fibrillation (AF) is a chronic cardiovascular disease, which can be divided into valvular atrial fibrillation and non-valvular atrial fibrillation. The thromboembolism caused by it is the most harmful complication to AF patients (20%): ischemic stroke. According to relevant statistical studies, more than 90% of the thrombus in patients with non-valvular atrial fibrillation originates from the left atrial appendage, and 60% of the thrombus in patients with valvular atrial fibrillation originates from the left atrial appendage. Patients with atrial fibrillation are five times more likely to cause a stroke than those without atrial fibrillation.


At present, the main methods for prevention and treatment of stroke caused by atrial fibrillation include long-term oral blood anticoagulants (LT-OAC), radiofrequency ablation (RFA) and so on. Although anticoagulant drugs (OAC) can significantly reduce the risk of complications of ischemic stroke, in certain specific populations, there is still a higher risk of bleeding; and RFA has obvious shortcomings, so it is less used in clinical practice. Therefore, a new treatment method for ischemic stroke caused by thromboembolism is urgently needed.


Left atrial appendage occlusion (LAAC) is a percutaneous minimally invasive interventional technique in which a left atrial appendage occluder is placed in the area of the left atrial appendage to block the left atrial appendage, thereby preventing blood from flowing into the left atrial appendage, so as to prevent thrombosis or thromboembolic events. It is mainly suitable for patients with atrial fibrillation who are at high risk of stroke, have contraindications to anticoagulation therapy, are at high risk of bleeding, or are unwilling to take anticoagulants for a long time, especially those over 75 years old.


2. The left atrial appendage occluder classified by structure

The structure of the left atrial appendage occluder can be roughly divided into integrated and split; according to the shape of the left atrial appendage, it can be divided into closed and open; according to the position of the barrier of the left atrial appendage occluder, it can be divided into built-in and external.


Most importantly, long-term clinical studies have shown that an ideal left atrial appendage occluder is a key factor in completing the occlusion of the left atrial appendage. The following conditions should be met: completely occlude the left atrial appendage, not fall off after implantation, no or less thrombotic, does not affect adjacent structures, is easy to plant, and can be retracted freely.

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