Percutaneous Occlusion of Left Atrial Appendage: Growing Clinical Experience and Lack of Multicenter Randomized Clinical Trials

Left atrial appendage (LAA) closure as a prophylactic strategy for thromboembolic events in patients with atrial fibrillation (AF) has been performed for decades; initially during mitral valve repair surgeries and, more recently, in nonvalvular AF patients at high risk of embolism who do not tolerate the use of oral anticoagulants (OACs).

The idea of LAA occlusion as an alternative to chronic warfarin use emerged from observations of anatomopathological studies and during cardiac surgery that disclosed the LAA as the main site of thrombus formation in patients with nonvalvular atrial fibrillation.^,

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