Isolated surgical left atrial appendage closure: Revisiting utility and indications in a burgeoning era of percutaneous therapy. Issue 6 (25th April 2020)

• Record Type: Journal Article
• Authors: Hernandez, Paula M.; Divakaran, Sanjay; Adler, Dale S.; Storms, Daniel R.; Kaneko, Tsuyoshi; Mohanty, Bibhu D.
• Is Part Of: Journal of cardiac surgery. Volume 35:Issue 6(2020)
• Page Start: 1360
• Page End: 1363
• Publication Date: 2020-04-25
• Subjects: atrial fibrillation -- cardiovascular pathology -- surgical excision -- watchman; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.14570
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background and Aim: Oral anticoagulation (AC) and percutaneous left atrial appendage (LAA) occlusion are the primary treatment modalities for stroke prevention in atrial fibrillation (AF), but there remains a subset of patients in whom these approaches present excess risk and isolated surgical LAA excision should be considered. We describe a 63‐year‐old female with AF and recurrent thromboembolic events who presented with an acute intraparenchymal hemorrhage and was found to have an intracardiac thrombus. Methods: Given contraindications to AC and LAA occlusion, an isolated LAA surgical excision was pursued. Results: She underwent successful surgical LAA excision and has since remained event‐free. Conclusion: It is important to recall the utility of therapies that have been previously used with success for intracardiac thrombi and still remain as viable options.