In Reply We thank Ahuja and colleagues for their comments regarding our recent sex-specific analysis of procedural outcomes among patients undergoing left atrial appendage occlusion (LAAO) using the National Cardiovascular Data Registry (NCDR).1 We reported that women were at higher risk of major adverse events compared with men undergoing LAAO, driven by major bleeding and pericardial effusions. While we suggested several potential mechanisms, such as anatomical differences and a more friable LAA, that may predispose women to increased risk of adverse events, these are merely hypotheses. It is likely that a multitude of factors play a role in the risk relationship, including the periprocedural antithrombotic regimen, as the authors suggest.
Darden D, Freeman JV, Hsu JC. To Occlude or Not to Occlude the Left Atrial Appendage in Women—Reply. JAMA Cardiol. 2022;7(4):464–465. doi:10.1001/jamacardio.2021.5933
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