[HSF] Routine closure of the left atrial appendage?

[erdinç naseri]

Ani,
I would prefer to have a neurologicaly intact patient with loss of some unknown endocrine fx rather than a completely normal endocrinologic patient with a major stroke.( and I think the patient would also vote in favor of the 1.st choice.
erdinc> From: anianyanwu at hotmail.com> To: openheart-l at lists.hsforum.com> Subject: RE: [HSF] Routine closure of the left atrial appendage?> Date: Wed, 18 Jul 2007 20:52:15 +0000> > A few years ago as a resident at Harefield I was once questioned by Yacoub as to why I was virtually obliterating the RA appengae while repairing a cannulation site. "The appendage is a delicate organ" he said .."it must be preserved at all costs - it is there for a reason". The next question which followed was "what are the endocrine functions of the atrial appendage?". Indeed if you watched yacoub cannulate he barely ever touched or instrumented the appendage and always left the patient with this structure anatomically intact. > > This stuck with me, not because of relevance or otherwise of the appendage but the realization that human bodies are complex and all parts have/had a part to play. We as surgeons should therefore not mutilate the human body at will and just cut and tie things because we can. Cut and do only what is necessary and leave others well alone, for we do not always know why they are there.> > Why don't you set up a randomized trial? If you demonstrate benefit and minimal risk to routine LAA exclusion then I am sure many will consider it. On the contrary if you find no benefit or harm then maybe Yacoub was right - the LA appendage is there for a reason and best left untouched.> > Ani> > > > > > > Date: Wed, 18 Jul 2007 12:16:23 -0500> From: mwertheimer at mahealthcare.com> To: OpenHeart-L at lists.hsforum.com> CC: > 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.> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> _________________________________________________________________> The next generation of MSN Hotmail has arrived - Windows Live Hotmail> http://www.newhotmail.co.uk_______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------