Javed Iqbal, Hamid Khalil, Qudsia Anjum Qureshi, Abdul Rehman Abid.
Effect of left Atrial appendage plication on cerebrovascular accidents secondary to atrial fibrillation in patients who underwent mitral valve surgery.
J Cardiovascular Dis Jan ;16(3):102-6.
BACKGROUND: Left atrial (LA) plication is a simple easy and cost effective surgical procedure. It is intended to alter the geometry and anatomy of LA supporting fibrillation. OBJECTIVE: To compare the effect of left atrial appendage exclusion in mitral valve surgery on future events of cerebrovascular accidents in comparison with non exclusion of left atrial appendage at five years of followup. MATERIAL AND METHODS: A retrospective study was conducted in three health facilities i.e. Pakistan Institute of Medical Sciences Islamabad, Quaid-e-Azam Hospital, Rawalpindi and Bilal Hospital from September, 2010 to April, 2017. Patients undergoing mitral valve surgery with plication/occlusion of Left Atrial appendage were enrolled in two groups: group A underwent MVR with LAA plication (n=60) and group B had MVR without LAA plication (n=60). Adult patients between16 years to 60 years of age and both genders were included. RESULTS: Females were predominant in this study. The duration of surgery was found out to be 68.0 minutes in group A as compared to 64.4 minutes in group B but not statistically significant. Similarly, the stay in the ICU and overall hospital stay was also found similar in both groups (p-value, 0.68). There was no statistically significant difference in postoperative atrial fibrillation thromboembolic events and functional capacity of the patients. CONCLUSION: There was no statistically significant benefit of LAA plication during Mitral valve surgery compared with non plication in terms of posteroperative Atrial fibrillation reduction and future thromboembolic events resulting in stroke.
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