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Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident

Background: Several surgical procedures such as excision or exclusion are recommended for the closure of the left atrial appendage (LAA). This study was conducted with the aim to evaluate the success rate of different surgical techniques for LAA closure, their respective complications, and the rate...

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Autores principales: Peighambari, Mohammad Mahdi, Moradkarami, Firoozeh, Sadeghpour, Anita, Baharestani, Bahador, Alizadeh-Ghavidel, Alireza, Ghadrdoost, Behshid, Etemadifar, Masoud, Behjati, Mohaddeseh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107571/
https://www.ncbi.nlm.nih.gov/pubmed/38011424
http://dx.doi.org/10.18502/cjn.v20i4.8350
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author Peighambari, Mohammad Mahdi
Moradkarami, Firoozeh
Sadeghpour, Anita
Baharestani, Bahador
Alizadeh-Ghavidel, Alireza
Ghadrdoost, Behshid
Etemadifar, Masoud
Behjati, Mohaddeseh
author_facet Peighambari, Mohammad Mahdi
Moradkarami, Firoozeh
Sadeghpour, Anita
Baharestani, Bahador
Alizadeh-Ghavidel, Alireza
Ghadrdoost, Behshid
Etemadifar, Masoud
Behjati, Mohaddeseh
author_sort Peighambari, Mohammad Mahdi
collection PubMed
description Background: Several surgical procedures such as excision or exclusion are recommended for the closure of the left atrial appendage (LAA). This study was conducted with the aim to evaluate the success rate of different surgical techniques for LAA closure, their respective complications, and the rate of post-surgical cerebrovascular accident (CVA). Methods: This retrospective study included 150 consecutive patients who underwent LAA closure most commonly after mitral valve surgery within 3 to 6 months after surgery. An expert echocardiographic fellow collected the data on patients’ surgical LAA closure methods and history of CVA, types of prosthetic valves, mortality, and bleeding. Results: The failure rate for complete LAA closure was 36.7% (55 patients) in our study. The greatest success rate of complete LAA closure was seen in purse-string method (75.5%), followed by resection method (71.4%), while the lowest success rate (≈ 33.3%) was observed in ligation method. A significant relationship was observed between clots on the surface of metallic valve and postoperative CVA (P = 0.001; likelihood ratio: 32).In multivariate analysis, there was also no statistically significant relationship between partial LAA closure and the incidence of post-surgical CVA (P > 0.050). Conclusion: We observed the highest success rate of complete LAA closure in purse-string method followed by resection method. Interestingly, our results showed that despite the higher rate of residual LAA clot in cases of partial LAA closure, the occurrence of post-surgical CVA was mostly related to the presence of clots on the surface of metallic mitral prostheses rather than the presence of partial LAA closure.
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spelling pubmed-91075712022-05-27 Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident Peighambari, Mohammad Mahdi Moradkarami, Firoozeh Sadeghpour, Anita Baharestani, Bahador Alizadeh-Ghavidel, Alireza Ghadrdoost, Behshid Etemadifar, Masoud Behjati, Mohaddeseh Curr J Neurol Original Article Background: Several surgical procedures such as excision or exclusion are recommended for the closure of the left atrial appendage (LAA). This study was conducted with the aim to evaluate the success rate of different surgical techniques for LAA closure, their respective complications, and the rate of post-surgical cerebrovascular accident (CVA). Methods: This retrospective study included 150 consecutive patients who underwent LAA closure most commonly after mitral valve surgery within 3 to 6 months after surgery. An expert echocardiographic fellow collected the data on patients’ surgical LAA closure methods and history of CVA, types of prosthetic valves, mortality, and bleeding. Results: The failure rate for complete LAA closure was 36.7% (55 patients) in our study. The greatest success rate of complete LAA closure was seen in purse-string method (75.5%), followed by resection method (71.4%), while the lowest success rate (≈ 33.3%) was observed in ligation method. A significant relationship was observed between clots on the surface of metallic valve and postoperative CVA (P = 0.001; likelihood ratio: 32).In multivariate analysis, there was also no statistically significant relationship between partial LAA closure and the incidence of post-surgical CVA (P > 0.050). Conclusion: We observed the highest success rate of complete LAA closure in purse-string method followed by resection method. Interestingly, our results showed that despite the higher rate of residual LAA clot in cases of partial LAA closure, the occurrence of post-surgical CVA was mostly related to the presence of clots on the surface of metallic mitral prostheses rather than the presence of partial LAA closure. Tehran University of Medical Sciences 2021-10-07 /pmc/articles/PMC9107571/ /pubmed/38011424 http://dx.doi.org/10.18502/cjn.v20i4.8350 Text en Copyright © 2021 Iranian Neurological Association, and Tehran University of Medical Sciences Published by Tehran University of Medical Sciences https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.
spellingShingle Original Article
Peighambari, Mohammad Mahdi
Moradkarami, Firoozeh
Sadeghpour, Anita
Baharestani, Bahador
Alizadeh-Ghavidel, Alireza
Ghadrdoost, Behshid
Etemadifar, Masoud
Behjati, Mohaddeseh
Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title_full Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title_fullStr Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title_full_unstemmed Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title_short Surgical left atrial appendage closure: Success rate and its relationship with cerebrovascular accident
title_sort surgical left atrial appendage closure: success rate and its relationship with cerebrovascular accident
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107571/
https://www.ncbi.nlm.nih.gov/pubmed/38011424
http://dx.doi.org/10.18502/cjn.v20i4.8350
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