The DOI matches its Crossref record; 59 of the 61 references it cites were found in a registry or an index.
Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation
Abstract
Background Left atrial appendage obliteration was historically ineffective for the prevention of postoperative stroke in patients with rheumatic atrial fibrillation who underwent operative mitral valvotomy. It is, however, a routine part of modern "curative" operations for nonrheumatic atrial fibrillation, such as the maze and corridor procedures.Methods To assess the potential of left atrial appendage obliteration to prevent stroke in nonrheumatic atrial fibrillation patients, we reviewed previous reports that identified the etiology of atrial fibrillation and evaluated the presence and location of left atrial thrombus by transesophageal echocardiography, autopsy, or operation.Results Twenty-three separate studies were reviewed, and 446 of 3,504 (13%) rheumatic atrial fibrillation patients, and 222 of 1,288 (17%) nonrheumatic atrial fibrillation patients had a documented left atrial thrombus. Anticoagulation status was variable and not controlled for. Thrombi were localized to, or were present in the left atrial appendage and extended into the left atrial cavity in 254 of 446 (57%) of patients with rheumatic atrial fibrillation. In contrast, 201 of 222 (91%) of nonrheumatic atrial fibrillation-related left atrial thrombi were isolated to, or originated in the left atrial appendage (p < 0.0001).Conclusions These data suggest that left atrial appendage obliteration is a strategy of potential value for stroke prophylaxis in nonrheumatic atrial fibrillation.
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“while AF implies an incremental risk for thromboembolism in patients with mitral valve stenosis”
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“The left atrial appendage (LAA) is recognized as an important source of thromboemboli in patients with atrial fibrillation.(1) Elimination of the LAA is believed to reduce stroke risk for patientswith atrial fibrillation; however, surgical LAA obliteration techniques have had variable success.”
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“It is also clear that the vast majority of thrombi in patients with nonvalvar AF are located in the left atrial appendage (LAA) (2).”
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“Atrial fibrillation (AF) is the most common cause of cardiogenic embolism, and more than 90% of embolic strokes result from thrombi in the left atrial appendage (LAA) [1, 2].”
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Left atrial appendage angiography for stroke risk prediction in patients with atrial fibrillation
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“It has been confirmed that LAA is the main source of stroke emboli in patients with atrial fibrillation [ 2 ].”
BackgroundPercutaneous Left Atrial Appendage Occlusion: What the Practising Physician Should Know
Merella, P., Talanas, G., Lorenzoni, G., Denurra, C., Atzori, E., & Casu, G. (2023) · European Cardiology Review · doi:10.15420/ecr.2023.18 · Cited by 4
“43 The explanation is summarised by Virchow’s triad: stasis of blood, hypercoagulability and endothelial injury.”
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“In a review of 23 studies, it was found that more than 90% of atrial thrombi are located in LAA in patients with non-valvular AF [7].”
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“91% of thrombi found in non-valvular AF and 50% in valvular AF were found in the LAA [12-17].”
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Mid-term Results for the Maze Procedure in Patients with Non-mitral Valvular Atrial Fibrillation
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“The majority (>90%) of thrombus formation in AF has been shown to originate from the left atrial appendage (LAA).(10,11) As a result, surgical closure of the LAA has been performed in an attempt to reduce stroke risk.”
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“Approximately 90% of thrombi in atrial fibrillation (AF) originate in the left atrial appendage (LAA) [1].”
Pradella, M., Baraboo, J. J., Chu, S. H., Maroun, A., Hwang, J. M., Collins, M. A., DiCarlo, A. L., Weiss, E. K., Zhao, L., PASSMAN, R. S., et al. (2025) · European Radiology · doi:10.1007/s00330-025-11866-w · Cited by 3
“This is of interest since the LAA is the primary location for thrombi found in the left heart, which are linked to stroke [23].”
Metadata
- Authors
- Blackshear, J. L., & Odell, J. A.
- Affiliations
- Mayo Clinic (US)
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 1996-02
- Volume
- 61
- Issue
- 2
- Pages
- 755-759
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2053482681
- Cited by
- 1,686
- References
- 61
- Citations by year
- 2026: 78 · 2025: 68 · 2024: 98 · 2023: 112 · 2022: 93 · 2021: 108 · 2020: 126 · 2019: 100 · 2018: 111 · 2017: 121 · 2016: 100 · 2015: 125 · 2014: 81 · 2013: 75 · 2012: 61
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- atrial fibrillation, postoperative stroke, stroke prevention, left atrial thrombus, non-valvular atrial fibrillation, cardiac surgery, mitral valve surgery, maze procedure, anticoagulation
- MeSH terms
- Contraindications, Aged, Atrial Fibrillation, Cerebrovascular Disorders, Heart Atria, Heart Diseases, Humans, Mitral Valve Stenosis, Postoperative Complications, Thrombosis, Warfarin
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