[HSF] Routine closure of the left atrial appendage?

[Nasser F. Abou'Seada]

Thanks Ed
I totally agree with your comments, concepts and thoughts.

NFA


On 7/27/07, Edward Bender <ebender001 at charter.net> wrote:
>
> There is nothing wrong with doing an indicated procedure by the most
> expeditious and inexpensive but safe way possible.  Suturing from the
> inside, from the outside, staples with or without pericardial strips
> have all been used by me and others with no untoward effects.  There
> is also a very small (but not zero) risk of bleeding, circumflex
> artery injury, mobilization of undetected thrombus.  The risks vary
> from patient-to-patient and from surgeon-to-surgeon.  I can
> unequivocally state that any complication from LAA ligation is an
> error, and it is up to the circumspect surgeon to decide whether it
> is an error in technique or judgement, and amend the technique or
> thought process.
>
> Ed Bender, MD
>
> On Jul 27, 2007, at 4:35 PM, Nasser F. Abou'Seada wrote:
>
> > may I ask a naive question ....
> > what is wrong with suturing the LAA in case it is indicated to be
> > obliterated ?
> > any reason to pay for more costly instruments / consumables ?
> >
> > NFA
> >
> >
> > On 7/23/07, Dr. Roberto Battellini <battr at medizin.uni-leipzig.de>
> > wrote:
> >>
> >> John,
> >> Is this clip similar to the cava clip? We used it in old times for
> >> pulmonary
> >> embolism before the umbrellas time.
> >> Roberto
> >>
> >> -----Ursprüngliche Nachricht-----
> >> Von: openheart-l-bounces at lists.hsforum.com
> >> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von
> >> Jbflegejr at aol.com
> >> Gesendet: Montag, 23. Juli 2007 15:35
> >> An: OpenHeart-L at lists.hsforum.com
> >> Betreff: Re: [HSF] Routine closure of the left atrial appendage?
> >>
> >> It seems to me that the Cosgrove clip is no more likely to secure
> >> reliable
> >> closure of the LAA than a stapler or for that matter a suture
> >> line. The
> >> line
> >> of
> >> closure can be same with all three methods, the problem of
> >> trabeculation
> >> on
> >> the atrial side of the closure would be the same, and risk to the
> >> circumflex
> >>
> >> coronary artery would be the same. Any of the three methods should
> >> be more
> >> effective that ligation. I predict that the clip will cost more than
> >> $1000;
> >> it
> >> wouldn't be worth developing for less. John Flege
> >>
> >>
> >>
> >> ************************************** Get a sneak peek of the all-
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