Refine
Has Fulltext
- yes (6)
Is part of the Bibliography
- yes (6)
Document Type
- Journal article (6)
Language
- English (6) (remove)
Keywords
- Akutes Nierenversagen (1)
- IABP (1)
- VA-ECMO (1)
- aortic valve replacement (1)
- atrial fibrillation (1)
- biological rapid deployment aortic valve (1)
- cadaver multiorgan preservation (1)
- coronary artery bypass grafting (1)
- cut and sew technique (1)
- extracorporeal membrane oxygenation (1)
- heart valve prosthesis (1)
- left atrial appendage occlusion (1)
- mild hypothermia (1)
- minimally invasive surgery (1)
- pCa (1)
- post-mortem heart recovery (1)
- postcardiotomy shock (1)
- postoperativ (1)
- right heart impairment (1)
- skinned fiber (1)
Institute
- Klinik und Poliklinik für Thorax-, Herz- u. Thorakale Gefäßchirurgie (6)
- Institut für Klinische Epidemiologie und Biometrie (2)
- Deutsches Zentrum für Herzinsuffizienz (DZHI) (1)
- Institut für Anatomie und Zellbiologie (1)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (1)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (1)
- Medizinische Klinik und Poliklinik I (1)
- Pathologisches Institut (1)
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.