Transcatheter left atrial appendage exclusion, gold or fool's gold?

Non-valvular atrial fibrillation (AF) related stroke primarily originates as embolic event from a left atrial appendage (LAA) thrombus. Oral anticoagulants effectively reduce stroke risk among AF patients. Cardiac operations are frequently coupled with surgical closure of the LAA as a measure to prevent stroke in such patients. Transcatheter LAA exclusion was first introduced in 2001, yet faced difficulties which led to the withdrawal of the initial device line. Recently, several events have revived the interest in this catheter-based technology as a safe and effective alternative to oral anticoagulants among AF patients. This review discusses the role of the LAA in health and disease and gives detailed insight into different transcatheter devices for LAA exclusion with the available clinical evidence.