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Comment & Response
February 16, 2022

To Occlude or Not to Occlude the Left Atrial Appendage in Women—Reply

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, University of California, San Diego
  • 2Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 3Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut
JAMA Cardiol. 2022;7(4):464-465. doi:10.1001/jamacardio.2021.5933

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.

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