Left Atrial Appendage Occlusion Study (LAAOS): Results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke - 21/08/11
, Eugene Crystal, MD b, Andre Lamy, MD a, Kevin Teoh, MD a, Lloyd Semelhago, MD a, Stefan H. Hohnloser, MD c, Irene Cybulsky, MD a, Labib Abouzahr, MD a, Corey Sawchuck, MD a, Sandra Carroll, BSc a, Carlos Morillo, MD a, Peter Kleine, MD c, Victor Chu, MD a, Eva Lonn, MD a, Stuart J. Connolly, MD aRésumé |
Aim |
This pilot study assessed the safety and efficacy of left atrial appendage (LAA) occlusion, performed at the time of coronary artery bypass grafting (CABG).
Methods and results |
At the time of CABG, 77 patients with risk factors for stroke were randomized to LAA occlusion or control. The LAA was occluded using sutures or a stapling device. Completeness of occlusion was assessed with transesophageal echocardiography. There were no significant differences in cardiopulmonary bypass duration, perioperative heart failure, atrial fibrillation, or bleeding between the 2 groups. During surgery, there were 9 appendage tears, all of which were repaired easily with sutures. Among patients having a postoperative transesophageal echocardiography, complete occlusion of the LAA was achieved in 45% (5/11) of cases using sutures and in 72% (24/33) using a stapler, P = .14. The rate of LAA occlusion by individual surgeons increased from 43% (9/21) to 87% (20/23) after performing 4 cases (P = .0001). After a mean follow-up of 13 ± 7 months, 2.6% of patients had thromboembolic events.
Conclusions |
LAA occlusion at the time of CABG is safe. The rate of complete occlusion improves, to acceptable levels, with increased experience and the use of a stapling device. A large trial is needed to determine if LAA occlusion prevents stroke.
Le texte complet de cet article est disponible en PDF.Plan
| Dr. Healey is supported by a research fellowship grant from the Heart and Stroke Foundation of Canada and Astra Zeneca Canada Ltd. |
Vol 150 - N° 2
P. 288-293 - août 2005 Retour au numéro
Article précédent
- Plasma low-density lipoprotein reduction and structural effects on coronary atherosclerotic plaques by atorvastatin as clinically assessed with intravascular ultrasound radio-frequency signal analysis: A randomized prospective study
- Masaki Yokoyama, Nobuyuki Komiyama, Brian K. Courtney, Takashi Nakayama, Susumu Namikawa, Nehiro Kuriyama, Tomomi Koizumi, Mizuo Nameki, Peter J. Fitzgerald, Issei Komuro
- Regional myocardial velocities and isovolumic contraction acceleration before and after device closure of atrial septal defects: A color tissue Doppler study
- Linda B. Pauliks, Kak-Chen Chan, Dennis Chang, Scott K. Kirby, Loralee Logan, Curt G. DeGroff, Mark M. Boucek, Lilliam M. Valdes-Cruz
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?