TY - JOUR
T1 - Impact of left atrial appendage exclusion on left atrial function
AU - Kamohara, Keiji
AU - Popović, Zoran B.
AU - Daimon, Masao
AU - Martin, Maureen
AU - Ootaki, Yoshio
AU - Akiyama, Masatoshi
AU - Zahr, Firas
AU - Cingoz, Faruk
AU - Ootaki, Chiyo
AU - Kopcak, Michael W.
AU - Dessoffy, Raymond
AU - Liu, Jenny
AU - Thomas, James D.
AU - Gillinov, A. Marc
AU - Fukamachi, Kiyotaka
N1 - Funding Information:
Supported by the Atrial Fibrillation Innovation Center, an Ohio Wright Center of Innovation, and by AtriCure, Inc, Cincinnati, Ohio. A.M.G. is a consultant to AtriCure, Inc. The Cleveland Clinic has an indirect interest in AtriCure, Inc, through its interest in a private fund that has an equity interest in AtriCure, Inc.
PY - 2007/1
Y1 - 2007/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jtcvs.2006.08.057
DO - 10.1016/j.jtcvs.2006.08.057
M3 - Article
C2 - 17198808
AN - SCOPUS:33845788064
SN - 0022-5223
VL - 133
SP - 174
EP - 181
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 1
ER -