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Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study.

De Maat GE, Benussi S, Hummel YM, Krul S, Pozzoli A, Driessen AH, Mariani MA, Van Gelder IC, Van Boven WJ, de Groot JR - Biomed Res Int (2015)

Bottom Line: Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005).However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline.The reduction of strain and strain rate was not significantly different between groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardio-Thoracic Surgery, University Medical Center Groningen, 9711 RB Groningen, Netherlands ; Department of Cardiology, University Medical Center Groningen, 9711 RB Groningen, Netherlands.

ABSTRACT

Background: In order to reduce stroke risk, left atrial appendage amputation (LAAA) is widely adopted in recent years. The effect of LAAA on left atrial (LA) function remains unknown. The objective of present study was to assess the effect of LAAA on LA function.

Methods: Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group), and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group). To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up.

Results: Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005). In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups.

Conclusions: In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.

No MeSH data available.


Related in: MedlinePlus

Strain rate bar graph.
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fig2: Strain rate bar graph.

Mentions: At a median of 12-month follow-up echocardiography, the LA diameter and volume indexed to BSA, in the LAAA group, was unchanged compared to baseline measurements (p = 0.530, p = 0.646, and p = 0.735, resp.). Compared to baseline, the strain measured at follow-up of the reservoir and conduit but not contractile phase had decreased (with p = 0.007, p = 0.014, and p = 0.070, resp.). In the strain rate domain, the reservoir function decreased accordingly, but this was not observed in the conduit and contractile phases (with p values of 0.029, 0.109, and 0.092, resp.) (Table 2 and Figure 2).


Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study.

De Maat GE, Benussi S, Hummel YM, Krul S, Pozzoli A, Driessen AH, Mariani MA, Van Gelder IC, Van Boven WJ, de Groot JR - Biomed Res Int (2015)

Strain rate bar graph.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4508381&req=5

fig2: Strain rate bar graph.
Mentions: At a median of 12-month follow-up echocardiography, the LA diameter and volume indexed to BSA, in the LAAA group, was unchanged compared to baseline measurements (p = 0.530, p = 0.646, and p = 0.735, resp.). Compared to baseline, the strain measured at follow-up of the reservoir and conduit but not contractile phase had decreased (with p = 0.007, p = 0.014, and p = 0.070, resp.). In the strain rate domain, the reservoir function decreased accordingly, but this was not observed in the conduit and contractile phases (with p values of 0.029, 0.109, and 0.092, resp.) (Table 2 and Figure 2).

Bottom Line: Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005).However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline.The reduction of strain and strain rate was not significantly different between groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardio-Thoracic Surgery, University Medical Center Groningen, 9711 RB Groningen, Netherlands ; Department of Cardiology, University Medical Center Groningen, 9711 RB Groningen, Netherlands.

ABSTRACT

Background: In order to reduce stroke risk, left atrial appendage amputation (LAAA) is widely adopted in recent years. The effect of LAAA on left atrial (LA) function remains unknown. The objective of present study was to assess the effect of LAAA on LA function.

Methods: Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group), and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group). To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up.

Results: Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005). In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups.

Conclusions: In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.

No MeSH data available.


Related in: MedlinePlus