Cor Vasa 2015, 57(3):e176-e180 | DOI: 10.1016/j.crvasa.2015.03.007

Clinical impact of left atrial appendage resection versus preservation during surgical ablation of atrial fibrillation

Vojtěch Kurfirst^a,b,*, Bohuslav Kuta^a, Júlia Čanádyová^a, Aleš Mokráček^a,b

^a Kardiochirurgické oddělení, Nemocnice České Budějovice, a. s., České Budějovice, Česká republika

^b Zdravotně sociální fakulta, Jihočeská univerzita, České Budějovice, Česká republika

Introduction: Resection of left atrial appendage (LAA) during surgical ablation of atrial fibrillation may decrease the incidence of postoperative cerebrovascular events and increase the induction and maintenance of sinus rhythm (SR). This study evaluates the effect of LAA resection after the surgical ablation of atrial fibrillation.

Materials and methods: A retrospective analysis was made of 599 patients who underwent surgical myocardial revascularization and/or valve surgery with concomitant surgical ablation of atrial fibrillation. The LAA was resected in 140 patients and preserved in 459 patients. Postoperative, 1-month and 1-year results were compared between the groups in terms of TIA/CVA, maintenance of sinus rhythm, pacemaker dependence and mortality.

Results: The patients who underwent LAA resection were older, had more frequent persistent AF and underwent more frequently biatrial ablation set. In this group, longer times of extracorporeal circulation and longer cross-clamp times were observed. During the follow-up period, the resection group has shown lower incidence of TIA/CVA and the overall mortality was also lower in this group of patients.

Conclusion: The resection group in our study has shown the trend toward lower incidence of TIA/CVA and statistically significant decrease of overall mortality. This finding can support routine LAA resection during surgical ablation of atrial fibrillation.

Keywords: Atrial fibrillation; Cerebrovascular event; LAA preservation; LAA resection

Received: January 25, 2015; Revised: March 5, 2015; Accepted: March 6, 2015; Published: June 1, 2015  Show citation