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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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Left atrial appendage elimination techniques: stapled excision versus internal suture obliteration.
Yoonjin Kang1, Ho Young Hwang1, Seohee Joo1
1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Journal of Thoracic Disease
|January 7, 2022
Summary
Stapled excision of the left atrium appendage (LAA) is more effective at preventing LAA remnants than suture obliteration. However, stapled excision carries a risk of bleeding complications.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Devices
Background:
- Surgical left atrium appendage (LAA) elimination is performed in patients with atrial fibrillation.
- Two common methods include stapled excision (SE) and internal suture obliteration (IO).
Purpose of the Study:
- To compare the efficacy and safety of LAA elimination using stapled excision versus internal suture obliteration.
- To evaluate LAA elimination failure and bleeding complications after surgical LAA closure.
Main Methods:
- A retrospective study of 158 patients with atrial fibrillation undergoing LAA elimination.
- Patients were divided into SE (n=102) and IO (n=56) groups.
- Postoperative computed tomography (CT) assessed LAA remnant or LA-LAA communication and bleeding at a median of 12.8 months.
Main Results:
- LAA elimination failure occurred in 4.9% of the SE group versus 16.1% of the IO group (P=0.036).
- A remnant LAA was observed in 5 SE patients and 9 IO patients.
- Bleeding complications occurred in 11.8% of the SE group versus 0% of the IO group (P=0.009).
Conclusions:
- Stapled excision demonstrates superior efficacy in LAA elimination compared to internal suture obliteration.
- Stapled excision is associated with a higher incidence of bleeding complications, necessitating careful technique to mitigate risks.
