TY  - JOUR
A1  - Radakovic, Dejan
A1  - Penov, Kiril
A1  - Lazarus, Marc
A1  - Madrahimov, Nodir
A1  - Hamouda, Khaled
A1  - Schimmer, Christoph
A1  - Leyh, Rainer G.
A1  - Bening, Constanze
T1  - The completeness of the left atrial appendage amputation during routine cardiac surgery
T2  - BMC Cardiovascular Disorders
N2  - Background
Left 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.

Methods
303 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.

Results
Average 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.

Conclusion
LAA amputation can be performed safely and completely leaving minimal to no LAA residual stump.
KW  - left atrial appendage occlusion
KW  - cut and sew technique
KW  - atrial fibrillation
Y1  - 2023
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/35737
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-357376
VL  - 23
ER  -