{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:48:05Z","timestamp":1778604485863,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous left atrial appendage closure (LAAC) is usually performed after a pre\u2010procedural evaluation by transesophageal echocardiography (TOE) or cardiac computed tomography angiography (CCTA). Nevertheless, these ad\u2010hoc examinations imply an additional use of hospital resources and time spending.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      To investigate long\u2010term clinical outcomes, effectiveness and safety of performing LAAC procedures without pre\u2010procedural imaging assessment in patients with high and very high thromboembolic risk based on CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From January 2016 to January 2023, 227 consecutive patients undergoing LAAC following an optimized pathway that removed the use of pre\u2010procedural TOE or CCTA imaging assessment, were enrolled in this single\u2010center, retrospective study. Patients were divided into two groups based on thromboembolic risk: 94 had CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc scores\u2009\u2265\u20095 and 133 had CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc scores\u2009&lt;\u20095). The primary endpoint was a composite of all\u2010cause death, stroke, systemic embolization, or bleeding events at 2 years. Co\u2010primary endpoints were device success, device\u2010related thrombosis (DRT) and peri\u2010device leaks (PDL)\u2009\u2265\u20093\u2009mm at TOE follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 2 years, no significant differences were observed between groups in the primary composite endpoint (KM est. 24.81% vs. 20.21%,\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>log\u2010rank<\/jats:sub>\n                      \u2009=\u20090.7; aHR 0.85, CI: 0.48\u22121.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.58). Device success was 98.7% overall, with no significant differences between groups (aOR 0.32% CI: 0.03\u22123.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.37). DRT and PDL\u2009\u2265\u20093\u2009mm rates were low (4.3% vs. 1.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26% and 3.2% vs. 2.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.75, respectively). In\u2010hospital complications were low and comparable in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In a consecutive series of patients undergoing LAAC, a simplified approach without pre\u2010operative imaging assessment showed comparable results at 2\u2010year for the primary composite endpoint of all\u2010cause death, stroke, systemic embolization, or bleeding events in patients with CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score\u2009\u2265\u20095 and those with CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score\u2009&lt;\u20095.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31613","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T02:25:01Z","timestamp":1747794301000},"page":"734-741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of CHA\n                    <sub>2<\/sub>\n                    DS\n                    <sub>2<\/sub>\n                    \u2010VASc Score in the Outcomes of Patients Undergoing a Simplified Pathway for Percutaneous Left Atrial Appendage Closure"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-4927","authenticated-orcid":false,"given":"Claudio","family":"Sanfilippo","sequence":"first","affiliation":[{"name":"Division of Cardiology Centro Cuore Morgagni Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6543-7567","authenticated-orcid":false,"given":"Marco","family":"Frazzetto","sequence":"additional","affiliation":[{"name":"School of Medicine, University Hospitals Harrington Heart &amp; Vascular Institute Case Western Reserve University Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-8988","authenticated-orcid":false,"given":"Giuliano","family":"Costa","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Contrafatto","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Giacalone","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Briguglio","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Barbera","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"De Santis","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Sanfilippo","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Castania","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Elena Di","family":"Salvo","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Scandura","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. Policlinico \u201cG. Rodolico San Marco\u201d Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-1242","authenticated-orcid":false,"given":"Guilherme","family":"Attizzani","sequence":"additional","affiliation":[{"name":"School of Medicine, University Hospitals Harrington Heart &amp; Vascular Institute Case Western Reserve University Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8364-1732","authenticated-orcid":false,"given":"Steven","family":"Filby","sequence":"additional","affiliation":[{"name":"School of Medicine, University Hospitals Harrington Heart &amp; Vascular Institute Case Western Reserve University Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Tamburino","sequence":"additional","affiliation":[{"name":"Division of Cardiology Centro Cuore Morgagni Catania Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Barbanti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Enna \u201cKore\u201d Enna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmelo","family":"Grasso","sequence":"additional","affiliation":[{"name":"Division of Cardiology A.O.U. 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