Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A systematic review

• Published in: Journal of interventional cardiac electrophysiology 2024-06, Vol.67 (4), p.865-885
• Main Authors: Helal, Baraa, Khan, Jibran, AlJayar, Dalia, Khan, Mohammad Salman, Alabdaljabar, Mohamad S., Asad, Zain Ul Abideen, DeSimone, Christopher V., Deshmukh, Abhishek
• Format: Article
• Language: English
• Subjects: Ablation; Appendages; Atrial Appendage - diagnostic imaging; Atrial Appendage - surgery; Atrial Fibrillation - surgery; Cardiology; Case reports; Criteria; Echocardiography; Female; Heart; Humans; Left Atrial Appendage Closure; Male; Medicine; Medicine & Public Health; Patients; Postoperative Complications - prevention & control; Radio frequency; Reviews; Risk Factors; Septal Occluder Device; Stroke; Stroke - etiology; Stroke - prevention & control; Systematic review; Thromboembolism
• ISSN: 1572-8595; 1383-875X; 1572-8595
• DOI: 10.1007/s10840-023-01729-z

Background Left atrial appendage closure (LAAC) is a treatment modality for stroke prevention in patients with atrial fibrillation (AF). One of the potential complications of LAAC is a peri-device leak (PDL), which could potentially increase the risk of thromboembolism formation. Methods This systematic review was done according to PRISMA guidelines. Using four databases, all primary studies through April 2022 that met selection criteria were included. Outcomes of interest were studies reporting on PDL characteristics, risk factors and management. Results A total of 116 studies met selection criteria (97 original studies and 19 case reports/series). In the original studies (n = 30,133 patients), the weighted mean age was 72.0 ± 7.4 years (57% females) with a HAS-BLED and CHA2DS2-VASc weighted means of 2.8 ± 1.1 and 3.8 ± 1.3, respectively. The most common definition of PDL was based on size; 5 mm: major, 3–5 mm: moderate,