Impact of left atrial appendage exclusion on left atrial function

Keiji Kamohara, Zoran B. Popović, Masao Daimon, Maureen Martin, Yoshio Ootaki, Masatoshi Akiyama, Firas Zahr, Faruk Cingoz, Chiyo Ootaki, Michael W. Kopcak, Raymond Dessoffy, Jenny Liu, James D. Thomas, A. Marc Gillinov, Kiyotaka Fukamachi

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10 Scopus citations

Abstract

Objectives: We sought to investigate the short-term and midterm effects of left atrial appendage exclusion on left atrial function. Left atrial appendage exclusion is considered a possible therapeutic option for stroke prevention in patients with atrial fibrillation. Favorable outcomes have encouraged widespread use of left atrial appendage exclusion for cardiac surgical patients-even for patients in sinus rhythm who have stroke risk factors; however, the chronic effects on left atrial function of left atrial appendage exclusion are unclear. Methods: Nineteen mongrel dogs (29.7 ± 5.2 kg) in sinus rhythm were studied. The Doppler signals from the pulmonary venous flow, transmitral flow, and tissue Doppler imaging of mitral annular motion were obtained before and after left atrial appendage exclusion. Dogs were evaluated in the same manner at 7 days (n = 2), 30 days (n = 7), or 90 days (n = 10) after left atrial appendage exclusion. Results: Except for a significant increase in early diastolic transmitral flow velocity after left atrial appendage exclusion (P = .01), no significant differences were found in any parameters related to the transmitral flow and tissue Doppler imaging measurements throughout follow-up. The systolic components of pulmonary venous flow at follow-up revealed a significant reduction relative to baseline (peak systolic velocity P < .0001, systolic velocity-time integral P < .0001), despite the lack of significant changes in left atrial pressure, left ventricular volume, and stroke volume. Conclusion: Left atrial appendage exclusion may affect left atrial reservoir function in the short-term and midterm periods. Further long-term studies with more clinically relevant models are needed.

Original languageEnglish (US)
Pages (from-to)174-181
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume133
Issue number1
DOIs
Publication statusPublished - Jan 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Kamohara, K., Popović, Z. B., Daimon, M., Martin, M., Ootaki, Y., Akiyama, M., ... Fukamachi, K. (2007). Impact of left atrial appendage exclusion on left atrial function. Journal of Thoracic and Cardiovascular Surgery, 133(1), 174-181. https://doi.org/10.1016/j.jtcvs.2006.08.057