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Minimally invasive, simplified double‐layer left atrial appendage closure
Author(s) -
Alnajar Ahmed,
Aberle Corinne,
Lamelas Joseph
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14563
Subject(s) - medicine , atrial fibrillation , stroke (engine) , thrombus , cardiology , embolism , mitral valve , cardiac surgery , appendage , closure (psychology) , surgery , embolic stroke , ischemic stroke , mechanical engineering , market economy , ischemia , economics , engineering , anatomy
Abstract The left atrial appendage (LAA) has been identified as a site of thrombus formation in the heart and as a source of embolism in patients with atrial fibrillation, leading to stroke. Studies suggest that LAA closure may reduce the risk for stroke and the need for anticoagulation; conversely, incomplete closure can increase the stroke risk almost 12‐fold. Because open heart surgery is associated with increased risk for subsequent stroke, surgeons generally prefer to close the LAA during heart surgery, as recommended in current atrial fibrillation management guidelines. Building on trends toward minimally invasive approaches in cardiac surgery, we developed a simple, unique, and reproducible method for complete LAA closure during mitral valve surgery that has proven to be safe and efficacious: Our first three patients remained completely free from stroke and minor neurological manifestations 27 months after surgery.