Concurrent surgical left atrial appendage occlusion should become routine procedure in cardiac surgery for atrial fibrillation patients — Commentary on LAAOS Ⅲ_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XU Yiwei , ZHU Yunpeng ,  ZHAO Qiang

Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P.R.China;

Corresponding author：

ZHAO Qiang, Email: zq11607@rjh.com.cn

Keywords：

Left atrial appendage occlusion; atrial fibrillation; stroke; systemic embolism

DOI：

10.7507/1007-4848.202106021

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Left atrial appendage occlusion is a common procedure for patients with atrial fibrillation history when they underwent cardiac surgery. Before the LAAOS Ⅲ research results, this operation has been lacking strong evidence-based support. LAAOS Ⅲ is a prospective, double-blind, international multicenter, randomized blinded trial. According to the results of LAAOS Ⅲ, the left atrial appendage occlusion can reduce the risk of stroke and systemic embolism. This article will perform detailed interpretation of LAAOS Ⅲ research.

Citation： XU Yiwei, ZHU Yunpeng, ZHAO Qiang. Concurrent surgical left atrial appendage occlusion should become routine procedure in cardiac surgery for atrial fibrillation patients — Commentary on LAAOS Ⅲ. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1016-1020. doi: 10.7507/1007-4848.202106021 Copy

1.	Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the framingham heart study: A cohort study. Lancet, 2015, 386(9989): 154-162.
2.	胡大一, 孙艺红, 周自强. 中国人非瓣膜性心房颤动脑卒中危险因素的病例对照研究. 中华内科杂志, 2003, 42(3): 157-161.
3.	Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke, 1991, 22(8): 983-988.
4.	Gage BF, van Walraven C, Pearce L, et al. Selecting patients with atrial fibrillation for anticoagulation: Stroke risk stratification in patients taking aspirin. Circulation, 2004, 110(6): 2287-2292.
5.	Stroke Prevention in Atrial Fibrillation Investigators. Study stroke prevention in atrial fibrillation study. Final results. Circulation, 1991, 84(2): 527-539.
6.	Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2): 755-759.
7.	Maunu N, Joonas L, Fausto B, et al. Preoperative paroxysmal atrial fibrillation predicts high cardiovascular mortality in patients undergoing surgical aortic valve replacement with a bioprosthesis: CAREAVR study. Clin Cardiol, 2020, 43(4): 401-409.
8.	Banach M, Goch A, Misztal M. et al Relation between postoperative mortality and atrial fibrillation before surgical revascularization—3-year follow-up. Thorac Cardiov Surg, 2008, 56(1): 20-23.
9.	Banach M, Rysz J, Drozdz J, et al. Risk factors of atrial fibrillation following coronary artery bypass grafting—A preliminary report. Circ J, 2006, 70(4): 438-441.
10.	Kazmierski J, Kowman M, Banach M, et al. Preoperative predictors of delirium after cardiac surgery: A preliminary study. Gen Hosp Psychiatry, 2006, 28(6): 536-538.
11.	Hoit BD, Shao Y, Tsai LM, et al. Altered left atrial compliance after atrial appendectomy. Influene on left atrial and ventricular filling. Circ Res, 1993, 72(1): 167-175.
12.	Philippe G, Borros A, Ferdinand S, et al. Influence of left atrial appendage amputation on natriuretic peptides—A randomized controlled trial. Thorac Cardiovasc Surg, 2021, 69(2): 117-123.
13.	Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2021, 42(5): 373-498.
14.	Healey JS, Crystal E, Lamy A, et al. Left atrial appendage occlusion study (LAAOS): Results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke. Am Heart J, 2005, 150(2): 288-293.
15.	Whitlock RP, Vincent J, Blackall MH, et al. Left Atrial Appendage Occlusion Study Ⅱ (LAAOS Ⅱ). Can J Cardiol, 2013, 29(11): 1443-1447.
16.	Whitlock RP, Belley-Cote EP, Paparella D. Left atrial appendage occlusion during cardiac surgery to prevent stroke. N Engl J Med, 2021, 384(22): 2081-2091.

1. Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the framingham heart study: A cohort study. Lancet, 2015, 386(9989): 154-162.
2. 胡大一, 孙艺红, 周自强. 中国人非瓣膜性心房颤动脑卒中危险因素的病例对照研究. 中华内科杂志, 2003, 42(3): 157-161.
3. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke, 1991, 22(8): 983-988.
4. Gage BF, van Walraven C, Pearce L, et al. Selecting patients with atrial fibrillation for anticoagulation: Stroke risk stratification in patients taking aspirin. Circulation, 2004, 110(6): 2287-2292.
5. Stroke Prevention in Atrial Fibrillation Investigators. Study stroke prevention in atrial fibrillation study. Final results. Circulation, 1991, 84(2): 527-539.
6. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996, 61(2): 755-759.
7. Maunu N, Joonas L, Fausto B, et al. Preoperative paroxysmal atrial fibrillation predicts high cardiovascular mortality in patients undergoing surgical aortic valve replacement with a bioprosthesis: CAREAVR study. Clin Cardiol, 2020, 43(4): 401-409.
8. Banach M, Goch A, Misztal M. et al Relation between postoperative mortality and atrial fibrillation before surgical revascularization—3-year follow-up. Thorac Cardiov Surg, 2008, 56(1): 20-23.
9. Banach M, Rysz J, Drozdz J, et al. Risk factors of atrial fibrillation following coronary artery bypass grafting—A preliminary report. Circ J, 2006, 70(4): 438-441.
10. Kazmierski J, Kowman M, Banach M, et al. Preoperative predictors of delirium after cardiac surgery: A preliminary study. Gen Hosp Psychiatry, 2006, 28(6): 536-538.
11. Hoit BD, Shao Y, Tsai LM, et al. Altered left atrial compliance after atrial appendectomy. Influene on left atrial and ventricular filling. Circ Res, 1993, 72(1): 167-175.
12. Philippe G, Borros A, Ferdinand S, et al. Influence of left atrial appendage amputation on natriuretic peptides—A randomized controlled trial. Thorac Cardiovasc Surg, 2021, 69(2): 117-123.
13. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2021, 42(5): 373-498.
14. Healey JS, Crystal E, Lamy A, et al. Left atrial appendage occlusion study (LAAOS): Results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke. Am Heart J, 2005, 150(2): 288-293.
15. Whitlock RP, Vincent J, Blackall MH, et al. Left Atrial Appendage Occlusion Study Ⅱ (LAAOS Ⅱ). Can J Cardiol, 2013, 29(11): 1443-1447.
16. Whitlock RP, Belley-Cote EP, Paparella D. Left atrial appendage occlusion during cardiac surgery to prevent stroke. N Engl J Med, 2021, 384(22): 2081-2091.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Concurrent surgical left atrial appendage occlusion should become routine procedure in cardiac surgery for atrial fibrillation patients — Commentary on LAAOS Ⅲ

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content