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Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia?
Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting 32 million individuals worldwide, particularly the elderly. It is the main cause of ischemic strokes. Oral anticoagulation (OAC) is the gold standard strategy for stroke prevention. Still, there is a not negligible share of pa...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314863/ https://www.ncbi.nlm.nih.gov/pubmed/35903669 http://dx.doi.org/10.3389/fcvm.2022.940560 |
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author | Belli, Martina Zanin, Federico Macrini, Massimiliano Barone, Lucy Marchei, Massimo Muscoli, Saverio Prandi, Francesca Romana Sergi, Domenico Di Luozzo, Marco Romeo, Francesco Barillà, Francesco |
author_facet | Belli, Martina Zanin, Federico Macrini, Massimiliano Barone, Lucy Marchei, Massimo Muscoli, Saverio Prandi, Francesca Romana Sergi, Domenico Di Luozzo, Marco Romeo, Francesco Barillà, Francesco |
author_sort | Belli, Martina |
collection | PubMed |
description | Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting 32 million individuals worldwide, particularly the elderly. It is the main cause of ischemic strokes. Oral anticoagulation (OAC) is the gold standard strategy for stroke prevention. Still, there is a not negligible share of patients who have contraindications to this therapy, more frequently due to an increased risk of bleeding. AF is often associated with moderate-severe mitral regurgitation (MR), the second most frequent valvular disease in elderly patients. Data from the literature reported that more than half of patients with severe mitral regurgitation are not suitable candidates for cardiac surgery. Given the progressive aging of the population and the simultaneous increase in the number of patients with comorbidities, the advent of new therapeutic strategies, such as the combined approach of Left Atrial Appendage Occlusion (LAAO) and MitraClip procedure, is acquiring great interest. At present, the category of patients who may benefit from combined percutaneous therapies and the long-term risks and benefits might not have been identified. Despite the efforts of researchers, the correct selection of patients is a very important clinical need that has not yet been met to avoid committing human and financial resources to interventions that may be unnecessary. It is conceivable that the most modern and recent innovations in cardiovascular imaging, particularly three-dimensional echocardiography and new methods of volume imaging, could improve our ability to select patients appropriately. Since data in the literature are scarce, future studies will be needed to evaluate the efficacy and safety of combined MitraClip and LAA occlusion. |
format | Online Article Text |
id | pubmed-9314863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93148632022-07-27 Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? Belli, Martina Zanin, Federico Macrini, Massimiliano Barone, Lucy Marchei, Massimo Muscoli, Saverio Prandi, Francesca Romana Sergi, Domenico Di Luozzo, Marco Romeo, Francesco Barillà, Francesco Front Cardiovasc Med Cardiovascular Medicine Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting 32 million individuals worldwide, particularly the elderly. It is the main cause of ischemic strokes. Oral anticoagulation (OAC) is the gold standard strategy for stroke prevention. Still, there is a not negligible share of patients who have contraindications to this therapy, more frequently due to an increased risk of bleeding. AF is often associated with moderate-severe mitral regurgitation (MR), the second most frequent valvular disease in elderly patients. Data from the literature reported that more than half of patients with severe mitral regurgitation are not suitable candidates for cardiac surgery. Given the progressive aging of the population and the simultaneous increase in the number of patients with comorbidities, the advent of new therapeutic strategies, such as the combined approach of Left Atrial Appendage Occlusion (LAAO) and MitraClip procedure, is acquiring great interest. At present, the category of patients who may benefit from combined percutaneous therapies and the long-term risks and benefits might not have been identified. Despite the efforts of researchers, the correct selection of patients is a very important clinical need that has not yet been met to avoid committing human and financial resources to interventions that may be unnecessary. It is conceivable that the most modern and recent innovations in cardiovascular imaging, particularly three-dimensional echocardiography and new methods of volume imaging, could improve our ability to select patients appropriately. Since data in the literature are scarce, future studies will be needed to evaluate the efficacy and safety of combined MitraClip and LAA occlusion. Frontiers Media S.A. 2022-07-12 /pmc/articles/PMC9314863/ /pubmed/35903669 http://dx.doi.org/10.3389/fcvm.2022.940560 Text en Copyright © 2022 Belli, Zanin, Macrini, Barone, Marchei, Muscoli, Prandi, Sergi, Di Luozzo, Romeo and Barillà. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Belli, Martina Zanin, Federico Macrini, Massimiliano Barone, Lucy Marchei, Massimo Muscoli, Saverio Prandi, Francesca Romana Sergi, Domenico Di Luozzo, Marco Romeo, Francesco Barillà, Francesco Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title | Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title_full | Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title_fullStr | Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title_full_unstemmed | Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title_short | Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a Utopia? |
title_sort | combined mitraclip and left atrial appendage occlusion: is it still a utopia? |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314863/ https://www.ncbi.nlm.nih.gov/pubmed/35903669 http://dx.doi.org/10.3389/fcvm.2022.940560 |
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