[HSF] Routine closure of the left atrial appendage?

[Nasser F. Abou'Seada]

Dear Hal
Is the issue how to close the LAA ? or rather why would it be closed ?
I would not use any fancy equipments should I decide to obliterate, cut the
LAA, simple ligature and stitching are safer and cheaper to my mind. but
still the issue remains: It can be be done, but should it be ?? and Why ?

NFA


On 7/18/07, hgrmd at aol.com <hgrmd at aol.com> wrote:
>
>
> Mark,
>
> ? I've heard this subject debated in the past.? The fact is most patients
> don't develop long term problems with AF after CABG.? Indeed, the LAA can be
> easily stapled.? However, the complication is low, but not zero.? There have
> been hemorrhagic fatalities associated with stapled closure of the LAA.? Try
> explaining that in court.?
>
> ? Atricure has a device in development that atraumatically closes the base
> of the appendage.? When it's finally released to the public, perhaps this
> will make the risk off LAA closure truly negligible.
>
>
>
> Hal
>
>
> -----Original Message-----
> From: Wertheimer MD, Mark <mwertheimer at mahealthcare.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wed, 18 Jul 2007 1:16 pm
> Subject: [HSF] Routine closure of the left atrial appendage?
>
>
>
>
> 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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