Left Atrial Appendage Closure Reduces the Incidence of Postoperative Cerebrovascular Accident in Patients Undergoing Cardiac Surgery

Background:Cerebrovascular accidents (CVA) are a major adverse event following cardiac surgery, for which atrial fibrillation (AF) is considered as a risk factor. We have recently performed left atrial appendage (LAA) surgical closure or amputation (LAAC/A), which is the main source of emboli, durin...

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Bibliographic Details
Published in:Circulation Journal 2015/11/25, Vol.79(12), pp.2591-2597
Main Authors: Kato, Tomoko S., Iwamura, Tai, Endo, Daisuke, Yokoyama, Yasutaka, Oishi, Atsumi, Shimada, Akie, Yamamoto, Taira, Kuwaki, Kenji, Inaba, Hirotaka, Amano, Atsushi
Format: Article
Language:English
Subjects:
Aged
Atrial fibrillation
Cardiac surgery
Cardiac Surgical Procedures - adverse effects
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cerebrovascular accident
Female
Humans
Incidence
Left atrial appendage
Male
Middle Aged
Postoperative Complications - epidemiology
Prospective Studies
Risk assessment
Risk Factors
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Summary:Background:Cerebrovascular accidents (CVA) are a major adverse event following cardiac surgery, for which atrial fibrillation (AF) is considered as a risk factor. We have recently performed left atrial appendage (LAA) surgical closure or amputation (LAAC/A), which is the main source of emboli, during open-heart surgery.Methods and Results:A prospective observational study of 1,831 consecutive patients (69.2% male, aged 66.8±12.2 years) undergoing cardiac surgery between 2009 and 2013 was performed. The incidence of postoperative CVA within 6 months in patients with and without LAAC/A was compared. We further stratified patients according to their risk of CVA using CHA2DS2-VASc score; dichotomizing low-risk (score
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-15-0524