A Contemporary Manual of Left Atrial Appendage Closure

Steven J. Filby, MD, is the director of the cardiac catheterization laboratory and program director for the interventional cardiology fellowship training program at University Hospitals Cleveland Medical Center.  He is an Associate Professor of Medicine at Case Western Reserve University, School of Medicine. Dr. Filby graduated from Harvard University with honors and obtained his medical degree from Louisiana State University School of Medicine in New Orleans. He completed his internal medicine residency at Stanford University Hospital and cardiology fellowship at University of North Carolina Health Care in Chapel Hill. Dr. Filby then completed a two year advanced fellowship in interventional cardiology, peripheral and structural intervention at the Cleveland Clinic. Dr. Filby is one of the University Hospitals "Distinguished Physician" and has been recognized as one of Cleveland Magazine's Top Doctors.

Luis Augusto Palma Dallan, MD, PhD, is an interventional cardiologist at the Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, OH, USA (2023) and the medical director, catheterization laboratory, UH Samaritan Medical Center, Ashland, OH. He is a Clinical Associate Professor of Medicine, Case Western Reserve University School of Medicine. He received his M.D. degree in medicine from Santa Casa de Misericordia de Sao Paulo, Brazil (2003). Fellowship in Cardiology at InCor - HCFMUSP - Heart Institute - Clinical Hospital Medical College - University of Sao Paulo (2008). Specialist in Cardiology conferred by SBC / AMB (2008). Specialist in Internal Medicine conferred by SBCM / AMB (2012). Specialist in Intensive Care conferred by AMIB / AMB (2012). Fellow in Hemodynamic and Interventional Cardiology at InCor - HCFMUSP (2010). Specialist in Hemodynamic and Interventional Cardiology conferred by SBHCI / AMB (2010). Previously assistant physician of Interventional Cardiology Department at InCor - Heart Institute - HCFMUSP. Doctorate - PhD in Cardiology Program, School of Medicine, University of Sao Paulo (2019). Foreign Sandwich-PhD Program - PDSE - CAPES by Case Western Reserve University, University Hospitals, Cleveland Medical Center - Ohio, USA. Post-Doctoral Research in Cardiology at Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (2020). Professor - Cardio-Pneumology Dept - FMUSP - School of Medicine - University of Sao Paulo (2020). Fellowship in Structural Heart Disease at Harrington Heart Vascular Institute, UH Cleveland Medical Center, Cleveland, OH (2022). 

Mauricio Arruda, MD, is the Director of Clinical Electrophysiology and Pacing at the University Hospitals Harrington Heart & Vascular Institute. He is also director of the Atrial Fibrillation Center.  Dr. Arruda is one of the University Hospitals "Distinguished Physician" and holds the distinguished "John R. Antonucci Master Clinician of Cardiovascular Innovation". Dr. Arruda is a Professor of Medicine at Case Western Reserve University, School of Medicine.

Section 1: Pre-Procedural Assessment.- Epidemiology: Atrial fibrillation, anticoagulation and stroke.- Current indications for left atrial appendage closure.- Anatomy of the left atrial appendage.- Pre-procedural planning for left atrial appendage closure: transesophageal echocardiography.- Pre-procedural planning for left atrial appendage closure: Cardiac computed tomography.- Pre-procedural planning for left atrial appendage closure: Cardiac Magnetic Resonance.- Section 2: Procedural Approach.- Same-day discharge for left atrial appendage closure.- Transseptal puncture: Best practice techniques.- Echocardiographic imaging guidance for left atrial appendage closure: transesophageal echocardiography (TEE).- Echocardiographic imaging guidance for left atrial appendage closure: intra-cardiac echocardiography (ICE).- Computed tomography-fluoro fusion guidance for left atrial appendage closure.- The WATCHMAN FLX left atrial appendage closure device: technical considerations and procedural approach.- The AMULET left atrial appendage closure device: technical considerations and procedural approach.- Novel percutaneous left atrial appendage closure devices.- Concomitant left atrial appendage closure & catheter ablation for atrial fibrillation.- Venous vascular closure devices.- Surgical treatment for left atrial appendage closure.- Section 3: Post-Procedural Management.- Post-procedural complications and management.- Post-procedural antiplatelet and anticoagulant strategies.- Post-procedural imaging and device-related features management.- Current evidence for left atrial appendage closure.- Shared decision-making and comprehensive atrial fibrillation management.- Future perspectives for left atrial appendage closure: CHAMPION-AF and CATALYST clinical trials.