초록접수 현황
| 20F-035 | 구연 발표 |
Efficacy of left atrial appendage elimination techniques: Stapled excision versus internal suture obliteration
Yoonjin Kang1, Ho Young Hwang1, Ji Hyeon Park1, Ji Seong Kim1, Suk Ho Sohn1, Jae Woong Choi1, Eun Ah Park2
1 Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea,
2 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
Purpose : This study was conducted to compare the safety and efficacy of the stapled left atrial appendage ([LA]A) excision with those of LAA internal suture obliteration.
Methods : 162 patients with atrial fibrillation who underwent surgical elimination of the LAA during cardiac surgery and underwent computed tomographic angiography (CTA) were enrolled. 102 patients underwent stapled excision (the LAAE group), and 60 patients underwent internal suture obliteration (the LAAIO group). The efficacy endpoint was LAA excision failure, which was defined as a remnant LAA (>1 cm), a communication between the LA and LAA or extravasation of radiocontrast dye. The CTA was performed at a median 13 (0.1-91) months.
Results : The efficacy endpoints were observed in 5 (4.9%) and 12 patients (20.0%) in the LAAE and LAAIO groups, respectively (p=0.002). In the LAAE group, LAA remnant was found in 5 patients and extravasation of the dye was not observed. In the LAAIO group, LAA remnant, a communication between the LA and LAA and both findings were observed in 8, 1 and 3 patients, respectively. In the LAAE group, staple line bleeding requiring reinforcement sutures occurred in 8 patients. Bleeding reoperation was needed in 7 (6.9%) and 2 patients (3.3%) in the LAAE and LAAIO groups, respectively, although none of the reoperations were related with LAA elimination sites.
Conclusion : Stapled excision of the LAA was associated with a lower rate of LAA elimination failure compared to the internal suture obliteration, although a caution might be needed to control staple line bleeding.
Methods : 162 patients with atrial fibrillation who underwent surgical elimination of the LAA during cardiac surgery and underwent computed tomographic angiography (CTA) were enrolled. 102 patients underwent stapled excision (the LAAE group), and 60 patients underwent internal suture obliteration (the LAAIO group). The efficacy endpoint was LAA excision failure, which was defined as a remnant LAA (>1 cm), a communication between the LA and LAA or extravasation of radiocontrast dye. The CTA was performed at a median 13 (0.1-91) months.
Results : The efficacy endpoints were observed in 5 (4.9%) and 12 patients (20.0%) in the LAAE and LAAIO groups, respectively (p=0.002). In the LAAE group, LAA remnant was found in 5 patients and extravasation of the dye was not observed. In the LAAIO group, LAA remnant, a communication between the LA and LAA and both findings were observed in 8, 1 and 3 patients, respectively. In the LAAE group, staple line bleeding requiring reinforcement sutures occurred in 8 patients. Bleeding reoperation was needed in 7 (6.9%) and 2 patients (3.3%) in the LAAE and LAAIO groups, respectively, although none of the reoperations were related with LAA elimination sites.
Conclusion : Stapled excision of the LAA was associated with a lower rate of LAA elimination failure compared to the internal suture obliteration, although a caution might be needed to control staple line bleeding.
책임저자: Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea
발표자: Yoonjin Kang, E-mail : yoonjin.r.kang@gmail.com