Evidence and Challenges in Left Atrial Appendage Management

Overview

Journal Ann Thorac Cardiovasc Surg

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2021 Aug 2

PMID 34334504

Citations 3

Authors

Taira Yamamoto

Daisuke Endo

Satoshi Matsushita

Akie Shimada

Keisuke Nakanishi

Tohru Asai

Atsushi Amano

Affiliations

Soon will be listed here.

Abstract

This review aimed to discuss the anatomical properties of the left atrial appendage (LAA), its relationship with atrial fibrillation (AF), effectiveness of LAA occlusion (LAAO), techniques, and new devices used to perform this procedure. An electronic search was performed to identify studies, in the English language, on LAA management. Searches were performed on PubMed Central, Scopus, and Medline from the dates of database inception to February 2020. For the assessed papers, data were extracted from the reviewed text, tables, and figures, by two independent authors. Anticoagulant therapy for patients with AF has proven beneficial and is highly recommended, but it is challenging for many patients to maintain optimal treatment. Surgery is the most cost-effective option; surgical methods include simple LAA resection, thoracoscopic surgery, and catheter treatment. Each procedure has its advantages and disadvantages, and many prospective studies have been conducted to evaluate various treatment methods. In managing the LAA, dissection of the LAA, such as changes in its shape and size due to remodeling during AF, changes in autonomic nerve function, and thrombosis, must be understood anatomically and physiologically. We believe that early treatment intervention for the LAA should be considered particularly in cases of recurrent AF.

Citing Articles

Left Atrial Appendage Closure With Catheter Ablation vs. Ablation Alone on Outcomes of Atrial Fibrillation in Heart Failure With Reduced Ejection Fraction: A Propensity Score-Matched Analysis.

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Congenital Absence of the Left Atrial Appendage: Role of Multimodality Imaging.

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Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke.

Wang Y, Wang M, Guo X, Han L, Kassab G Front Bioeng Biotechnol. 2023; 11:1011121.

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