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Master Thesis

Assessement of antithrombotic strategy after left atrial appendage closure by a watchman device - a regional experience

Abstract : The left appendage occlusion by Watchman device is possible in patients suffering from atrial fibrillation and unsuitable for anticoagulation treatment. However, post procedural treatment is still in debate. The aim of this study is to compare the efficacy and safety of each post-operative antithrombotic strategy. METHODS: An observational and multicentric study included all consecutive patients implanted with a Watchman device between January 2013 and december 2018 in the niversity hospital of Grenoble, Lyon and Saint-Etienne was performed. The primary efficacy endpoint was the occurrence of thromboembolic event, major bleeding or death within a year following implantation. The primary safety endpoint was a composite criterion of procedural complications or major bleeding during follow up. The groups of treatment compared no treatment, single or dual antiplatelet therapy. RESULTS: 295 patients were included, the mean age was 77years and the mean scores CHAD2S2 VASc and HAS BLED were respectively 4,92 and 3,65. There were no statistical difference in the occurrence of the primary criterion between the three groups (p= 0,83). No additional risk depending on treatment was found. There was a risk reduction of 54% in thromboembolic events and 72% in major bleeding in comparison to the expected rate estimated by the scores. CONCLUSION: There was no difference of embolic events, major bleeding or death depending on the chosen treatment. No specific profile was found to help choosing medication. It seems possible to simplify the post procedural treatment by a single anti aggregation for fragile patients.
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Master Thesis
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Submitted on : Wednesday, June 30, 2021 - 2:04:38 PM
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Anne Guenet. Assessement of antithrombotic strategy after left atrial appendage closure by a watchman device - a regional experience. Human health and pathology. 2020. ⟨dumas-02954585⟩

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