Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study.

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Left atrial appendage amputation (LAAA) is increasingly used to reduce stroke risk.
• The impact of LAAA on left atrial (LA) function is not well understood.
• This study aimed to evaluate the effect of LAAA on LA function.

Purpose of the Study:

• To assess the impact of left atrial appendage amputation (LAAA) on left atrial (LA) function.
• To compare LA function in patients who underwent LAAA versus those who did not.
• To determine if LAAA has late functional consequences on the LA.

Main Methods:

• Retrospective matched-group comparison of 16 patients undergoing thoracoscopic pulmonary vein isolation (PVI) with LAAA and 16 patients undergoing PVI without LAA amputation.
• Transthoracic echocardiography with 2D Speckle Tracking used to assess LA function.
• Measurements performed pre-surgery and at 12-month follow-up.

Main Results:

• No significant reduction in contractile LA function or LA ejection fraction in either group.
• Significant decrease in LA conduit and reservoir function observed at follow-up in both groups compared to baseline.
• No significant difference in the reduction of LA strain and strain rate between the LAAA and non-LAAA groups.

Conclusions:

• LAAA does not appear to impair contractile LA function compared to non-amputation.
• Both LAAA and non-LAAA groups experienced reduced LA conduit and reservoir function, suggesting these changes may be related to the PVI procedure itself.
• LAA removal may be performed without significant long-term adverse effects on LA contractile function.