Key result
Cut-and-sew LAA amputation during cardiac surgery achieves complete resection in 99% of patients.
Why the study?
The study aimed to prove the safety and low complication rate of surgical left atrial appendage amputation using the cut-and-sew technique while controlling for its effectiveness.
Does LAA amputation using a cut and sew technique safely achieve complete exclusion in patients undergoing routine open-heart surgery?
Observational (n=303)
No
Does LAA amputation using a cut and sew technique safely achieve complete exclusion in patients undergoing routine open-heart surgery?
LAA amputation using a cut and sew technique during routine cardiac surgery is safe and achieves complete exclusion (stump < 1 cm) in 99% of patients without significantly increasing bleeding risk.
Supports cut-and-sew LAA amputation feasibility in open-heart surgery; extends observational data but leaves open randomized outcome trials.
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.
No takes yet. Share an insight, caveat, or question.
Radaković et al. (2023) conducted an observational in Patients undergoing routine open-heart surgery (n=303). Left atrial appendage (LAA) amputation using cut and sew technique was evaluated on Completeness of amputation (residual stump < 1 cm). Left atrial appendage amputation using the cut and sew technique during routine cardiac surgery achieved complete resection with a residual stump < 1 cm in 99% of patients and a 1% rate of postoperative bleeding.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: