Epicardial Surgical Ligation of the Left Atrial Appendage is Safe, Reproducible, and Effective by Transesophageal Echocardiographic Follow-up

医学 心房颤动 结扎 围手术期 心脏病学 内科学 心耳 Prolene 外科 纤维接头 窦性心律
作者
Alex Zapolanski,Christopher K. Johnson,Omid Dardashti,Ryan OʼKeefe,Nancy Rioux,Giovanni Ferrari,Richard E. Shaw,Mariano E. Brizzio,Juan B. Grau
出处
期刊:Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery [SAGE]
卷期号:8 (5): 371-375 被引量:23
标识
DOI:10.1097/imi.0000000000000022
摘要

The left atrial appendage (LAA) is the source of 90% of thrombi in patients with atrial fibrillation. Our double LAA ligation (LLAA) technique was shown to be 96% successful in a small study. However, the outcomes of these patients have yet to be compared with a set of nonligated patients.From 2005 to 2012, a total of 808 patients received LAA using our double ligation technique using both a polydioxanone (PDS) II endosnare and a running 4-0 Prolene pledgeted suture. The 30-day outcomes of these patients were compared with that of nonligated patients. Fifty-six of the ligated patients had a postoperative transesophageal echocardiography (TEE). An echocardiographer reviewed the follow-up TEEs for LAA remnant and/or residual flow into the LAA using color Doppler imaging. The patients with LAA flow and/or remnant depth of 1 cm or greater were deemed to have an unsuccessful exclusion.The ligated group had a trend of less postoperative atrial fibrillation (19.4% vs 22.9%, P = 0.07) and an overall significantly lower in-hospital mortality (0.7% vs 3.0%, P < 0.001) and lower 30-day mortality (0.7% vs 3.4%, P < 0.0001). The LAA was successfully excluded in 53 (94.7%) of the 56 patients with TEE.Double LAA ligation correlates with lower rates of in-hospital and 30-day mortality. This advantage comes without an increase in perioperative complications. This technique can easily be performed off or on pump, is very reproducible, and comes at a very low cost compared with LAA occlusion devices. Stroke has a multifactorial etiology; successful LLAA removes one potential source of thrombi perioperatively and in the long-term.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
爱笑的如霜完成签到,获得积分20
3秒前
5秒前
skikiqi发布了新的文献求助10
5秒前
6秒前
8秒前
Hsevencc完成签到 ,获得积分10
9秒前
123完成签到,获得积分20
9秒前
江小鱼在查文献完成签到,获得积分10
9秒前
fighting完成签到 ,获得积分10
9秒前
是风动完成签到 ,获得积分10
10秒前
11秒前
SciGPT应助Qiang采纳,获得10
11秒前
11秒前
eason应助wj18637196763采纳,获得10
12秒前
英姑应助123采纳,获得20
13秒前
Neinei发布了新的文献求助10
13秒前
渴望挪例聚完成签到,获得积分10
13秒前
杳鸢应助热塑性哈士奇采纳,获得10
13秒前
13秒前
脆脆大王完成签到,获得积分10
14秒前
車侖完成签到 ,获得积分10
14秒前
qiannnn发布了新的文献求助10
15秒前
16秒前
快递乱跑完成签到 ,获得积分10
16秒前
苗小七完成签到,获得积分10
16秒前
JamesPei应助西瓜xg采纳,获得10
17秒前
冷傲半邪发布了新的文献求助10
17秒前
MateoX发布了新的文献求助10
17秒前
18秒前
张成完成签到,获得积分10
19秒前
执着应助yyp采纳,获得10
21秒前
丸子完成签到 ,获得积分10
21秒前
LJ完成签到,获得积分10
22秒前
bxg发布了新的文献求助10
22秒前
23秒前
青红造了个白完成签到,获得积分20
23秒前
Neinei完成签到,获得积分20
24秒前
Lucas应助的士速递采纳,获得10
24秒前
lin完成签到,获得积分10
26秒前
Luna完成签到 ,获得积分10
26秒前
高分求助中
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Structural Load Modelling and Combination for Performance and Safety Evaluation 1000
Conference Record, IAS Annual Meeting 1977 820
England and the Discovery of America, 1481-1620 600
電気学会論文誌D(産業応用部門誌), 141 巻, 11 号 510
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3571735
求助须知:如何正确求助?哪些是违规求助? 3142208
关于积分的说明 9446367
捐赠科研通 2843644
什么是DOI,文献DOI怎么找? 1562971
邀请新用户注册赠送积分活动 731508
科研通“疑难数据库(出版商)”最低求助积分说明 718557