| 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. | |
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MedLine Citation:
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PMID: 16086933 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: This pilot study assessed the safety and efficacy of left atrial appendage (LAA) occlusion, performed at the time of coronary artery bypass grafting (CABG). METHODS AND RESULTS: At the time of CABG, 77 patients with risk factors for stroke were randomized to LAA occlusion or control. The LAA was occluded using sutures or a stapling device. Completeness of occlusion was assessed with transesophageal echocardiography. There were no significant differences in cardiopulmonary bypass duration, perioperative heart failure, atrial fibrillation, or bleeding between the 2 groups. During surgery, there were 9 appendage tears, all of which were repaired easily with sutures. Among patients having a postoperative transesophageal echocardiography, complete occlusion of the LAA was achieved in 45% (5/11) of cases using sutures and in 72% (24/33) using a stapler, P = .14. The rate of LAA occlusion by individual surgeons increased from 43% (9/21) to 87% (20/23) after performing 4 cases (P = .0001). After a mean follow-up of 13 +/- 7 months, 2.6% of patients had thromboembolic events. CONCLUSIONS: LAA occlusion at the time of CABG is safe. The rate of complete occlusion improves, to acceptable levels, with increased experience and the use of a stapling device. A large trial is needed to determine if LAA occlusion prevents stroke. |
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Authors:
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Jeff S Healey; Eugene Crystal; Andre Lamy; Kevin Teoh; Lloyd Semelhago; Stefan H Hohnloser; Irene Cybulsky; Labib Abouzahr; Corey Sawchuck; Sandra Carroll; Carlos Morillo; Peter Kleine; Victor Chu; Eva Lonn; Stuart J Connolly |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 150 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-09 Completed Date: 2005-12-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 288-93 Citation Subset: AIM; IM |
Affiliation:
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McMaster University, Hamilton, Ontario, Canada. healeyj@hhsc.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atrial Appendage / surgery*, ultrasonography Atrial Fibrillation / complications Brain Ischemia / epidemiology Coronary Artery Bypass / methods* Coronary Disease / complications, surgery Echocardiography, Transesophageal Female Heart Failure / epidemiology Humans Hypertension / complications Intracranial Embolism / etiology, prevention & control* Intraoperative Complications / epidemiology Ligation Male Pilot Projects Postoperative Complications / epidemiology, prevention & control* Postoperative Hemorrhage / epidemiology Risk Factors Surgical Stapling Suture Techniques Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Am Heart J. 2006 Jun;151(6):e1; author reply e3
[PMID:
16781207
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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