[HSF] Routine closure of the left atrial appendage?

[Nasser F. Abou'Seada]

in TVMC I was taught to close the LAA, by definition the site of finger
introduction and palpation of the right index finger to palpate, evaluate,
split the mitral valve commissures. yet however, closure of the incision of
the LAA doesn't mean ligation / obliteration, rather closure of the incision
meticulously. nonetheless, I have seen many who would ligate the LAA after
clampling, for safety reasons. a routine obliteration was a must only in
cases of AF, not unusual in cases of pure MS.

NFA


On 7/18/07, prasannasimha <prasannasimha at gmail.com> wrote:
>
> I Ligate the LA appendage of all mitrals. The incidence of Afib post
> cardiac surgery in India is very low (we see probably  1-3 cases in a
> year post CABG) and is similar in other centers so we do not do it.I am
> not really sure of the reason. External ligation is easy and cheap
> instead of all those fancy devices and we have been doing it for years
> when we were doing CMV's regularly.
> Prasanna
> Wertheimer MD, Mark wrote:
> > Given the substantial incidence of atrial fibrillation following cardiac
> > surgery, and the frequent need to place many of these patients on
> > Coumadin anticoagulation to reduce the risks of embolic stroke, has
> > anyone gone to routinely closing off the left atrial appendage with all
> > cardiac surgeries?  It can be easily done with the use of the noncutting
> > endo- stapling device.
> >
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