Surgical strategies and devices for surgical exclusion of the left atrial appendage: a word of caution

J Card Surg. 2013 Mar;28(2):199-206. doi: 10.1111/jocs.12055. Epub 2013 Jan 20.

Abstract

In patients with chronic atrial fibrillation, 90% of clots are located in the left atrial appendage (LAA). Therefore, LAA exclusion is a means of preventing thrombus formation and subsequent thromboembolic events in these patients. The LAA can be excluded from the systemic circulation via surgical, percutaneous, or thoracoscopic approaches. The surgical aim is complete obliteration of the appendage without a significant increase in either postoperative complications (bleeding, arrhythmias) or recurrence. We discuss the current surgical techniques available for LAA obliteration and review their results.

Publication types

  • Review

MeSH terms

  • Atrial Appendage / surgery*
  • Atrial Fibrillation / complications*
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods
  • Heart Diseases / etiology
  • Heart Diseases / prevention & control*
  • Humans
  • Ligation
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Suture Techniques
  • Thoracoscopy
  • Thrombosis / etiology
  • Thrombosis / prevention & control*
  • Treatment Outcome