Concomitant Left Atrial Appendage Amputation Using a Stapler during Cardiovascular Surgery

Masakazu Aoki; Hiroshi Furuhata; Toshikazu Shimizu; Riki Sumiyoshi; Hiroshi Nagano; Hideki Morita; Hiromasa Kawaura

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Concomitant Left Atrial Appendage Amputation Using a Stapler during Cardiovascular Surgery

VernacularTitle:開心術症例に対するステイプラーを使用した左心耳切除の手術成績と問題点
Author: Masakazu AOKI ¹ ; Hiroshi FURUHATA ¹ ; Toshikazu SHIMIZU ¹ ; Riki SUMIYOSHI ¹ ; Hiroshi NAGANO ¹ ; Hideki MORITA ¹ ; Hiromasa KAWAURA ²
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1. Department of Cardiovascular Surgery, Saitama Red Cross Hospital
2. Department of Emergency, Saitama Red Cross Hospital
Keywords: postoperative atrial fibrillation; cardiogenic cerebral embolism; left atrial appendage closure; stapler
From:Japanese Journal of Cardiovascular Surgery 2019;48(2):97-102
CountryJapan
Language:Japanese
Abstract: Objective : The objective of this study was to assess the safety and efficacy of left atrial appendage (LAA) amputation during cardiovascular surgery. Methods : Fifty-seven patients underwent LAA amputation using a stapler from 2016 to 2017. The presence of remnant LAA was estimated by transesophageal echocardiography (TEE). Results : All LAA amputations were performed with the heart beating, without collapse. Additional amputation for remnant LAA was required in 14 patients. Sutures were needed to control bleeding in 7 patients. There was one case in which the coronary artery ended up being clamped with the LAA. The average duration for LAA amputation was 6.1±3.2 (1.5-15.2) min. There were 25 cases with postoperative atrial fibrillation (POAF), one case of cerebral infarction without POAF and one case of re-exploration for bleeding. Three patients died during hospitalization. Conclusion : LAA amputation using a stapler does not require cardiac arrest, and rarely requires an extended operation time. However, sufficient caution is required as there is the possibility that the coronary artery is obstructed and that remnant LAA is present.