The completeness of the left atrial appendage amputation during routine cardiac surgery

BMC Cardiovascular Disorders

Research

Marc Lazarus¹  Khaled Hamouda²  Nodir Madrahimov²  Christoph Schimmer²  Constanze Bening²  Dejan Radakovic²  Kiril Penov²  Rainer G. Leyh² 

[1] Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany;Department of Thoracic and Cardiovascular Surgery, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany;

关键词: Left atrial appendage occlusion;    Cut and sew technique;    Atrial fibrillation;   

DOI  :  10.1186/s12872-023-03330-8

 received in 2023-02-18, accepted in 2023-06-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLeft atrial appendage (LAA) is the origin of most heart thrombi which can lead to stroke or other cerebrovascular event in patients with non-valvular atrial fibrillation (AF). This study aimed to prove safety and low complication rate of surgical LAA amputation using cut and sew technique with control of its effectiveness.Methods303 patients who have undergone selective LAA amputation were enrolled in the study in a period from 10/17 to 08/20. The LAA amputation was performed concomitant to routine cardiac surgery on cardiopulmonary bypass with cardiac arrest with or without previous history of AF. The operative and clinical data were evaluated. Extent of LAA amputation was examined intraoperatively by transoesophageal echocardiography (TEE). Six months in follow up, the patients were controlled regarding clinical status and episodes of strokes.ResultsAverage age of study population was 69.9 ± 19.2 and 81.9% of patients were male. In only three patients was residual stump after LAA amputation larger than 1 cm with average stump size 0.28 ± 0.34 cm. 3 patients (1%) developed postoperative bleeding. Postoperatively 77 (25.4%) patients developed postoperative AF (POAF), of which 29 (9.6%) still had AF at discharge. On 6 months follow up only 5 patients had NYHA class III and 1 NYHA class IV. Seven patients reported with leg oedema and no patient experienced any cerebrovascular event in early postoperative follow up.ConclusionLAA amputation can be performed safely and completely leaving minimal to no LAA residual stump.

【 授权许可】

CC BY   
© The Author(s) 2023

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