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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“Compelling evidence has revealed that the left atrial appendage (LAA) is implicated as the source of thrombus in more than 90% of strokes in AF [6].”
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“Study patients in the LAA thrombus group (n = 102) had to meet the following inclusion criteria: (1) age >18 years, (2) history of AF, and (3) TEE of the LAA with thrombus confirmed by two noninvasive physicians on independent review.”
MethodRight Atrial Appendage Thrombus in Atrial Fibrillation: A Case Report and Review of the Literature
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Lüscher, T. F., Davies, A., Beer, J. H., Valgimigli, M., Nienaber, C. A., Camm, A. J., Baumgärtner, I., Diener, H., & Konstantinides, S. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab642 · Cited by 18
Risk of Stroke With Mitral Stenosis: The Underlying Mechanism, Treatment, and Prevention
Islam, H., Puttagunta, S. M., Islam, R., Kundu, S., Jha, S. B., Rivera, A. P., Monar, G. V. F., & Sange, I. (2022) · Cureus · doi:10.7759/cureus.23784 · Cited by 19
“It creates a favorable environment for blood stasis, making the LAA a key location of thrombus production in AF [22].”
BackgroundImaging Modality to Guide Left Atrial Appendage Closure: Current Status and Future Perspectives
Laterra, G., Dattilo, G., Correale, M., Brunetti, N. D., Artale, C., Sacchetta, G., Pistelli, L., Borgi, M., Campanella, F., Cocuzza, F., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12113756 · Cited by 17
“demonstrated that thrombus was present in about 17% of patients with non-valvular AF and of these, in 91% of cases it was localized in LAA [20].”
BackgroundFranchin, L., Piroli, F., Demola, P., Mantovani, F., Iannaccone, M., Manfredi, R., D’Ascenzo, F., Fortuni, F., Ugo, F., Meucci, F., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1212161 · Cited by 17
“Several studies have shown that the left atrial appendage is the most common site of intracardiac thrombi (1, 2) even in patients with sinus rhythm (3).”
BackgroundOchiumi, Y., Kagawa, E., Kato, M., Sasaki, S., Nakano, Y., Itakura, K., Takiguchi, Y., Ikeda, S., & Dote, K. (2015) · Journal of Arrhythmia · doi:10.1016/j.joa.2015.04.002 · Cited by 17
“LAA thrombus is reported to be associated with the D-dimer level and thromboembolism in patients with NVAF [7–10].”
BackgroundLeft Atrial Appendage Closure with Transcatheter-Delivered Devices
Whisenant, B. K., & Weiß, P. J. (2014) · Interventional Cardiology Clinics · doi:10.1016/j.iccl.2014.01.002 · Cited by 17
Occlusion of canine atrial appendage using an expandable silicone band
McCarthy, P. M., Lee, R., Foley, J. L., Phillips, L. A., Kanayinkal, T., & Francischelli, D. E. (2010) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2010.01.015 · Cited by 17
“E T /B S The left atrial appendage (LAA) is a common site of thrombus formation in patients with cardiovascular disease.(1,2) Surgical exclusion of the LAA is recommended in the current American Heart Association/American College of Cardiology guidelines for patients with mitral valve disease at the time of mitral val…”
BackgroundPercutaneous left atrial appendage closure
Jazayeri, M., Vuddanda, V. L. K., Parikh, V. K., & Lakkireddy, D. (2016) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000367 · Cited by 17
Left Atrial Appendage Occlusion: Past, Present and Future
Ding, W. Y., Mandrola, J. M., & Gupta, D. (2020) · Thrombosis and Haemostasis · doi:10.1055/s-0040-1714654 · Cited by 17
Rocca, D. G. D., Horton, R., Tarantino, N. M., Niekerk, C. J. V., Trivedi, C. G., Chen, Q., Mohanty, S., Anannab, A., Murtaza, G., Akella, K., et al. (2020) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.120.009227 · Cited by 17
Lindner, S., Behnes, M., Wenke, A., Sartorius, B., Akin, M., Mashayekhi, K., Gawlitza, J. F., Weidner, K., Ansari, U., Haubenreisser, H., et al. (2021) · International journal of cardiac imaging · doi:10.1007/s10554-021-02192-5 · Cited by 17
“In most cases, thrombi originate from the left atrial appendage (LAA) [1, 2].”
BackgroundSaad, M. F., Risha, O., Sano, M., Fink, T., Heeger, C.-H. H., Vogler, J., Sciacca, V., Eitel, C., Stiermaier, T., Joost, A., et al. (2021) · IJC Heart & Vasculature · doi:10.1016/j.ijcha.2021.100893 · Cited by 17
Left Atrial Appendage Occlusion for Stroke Prevention
Alli, O. O., & Holmes, D. R. (2012) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2012.06.001 · Cited by 17
“6 Furthermore, SPINAF data suggest that 15% of patients with atrial fibrillation suffer silent cerebral infarctions on computed tomography, the implications of which are unknown.(7) Oral anticoagulant (OAC) therapy with warfarin has been established as the standard for stroke prevention in patients with AF who have mo…”
Madsen, C. V., Park-Hansen, J., Holme, S. J. V., Irmukhamedov, A., Carranza, C. L., Greve, A. M., Al-Farra, G. J., Riis, R., Nilsson, B., Clausen, J. S. R., et al. (2022) · Seminars in Thoracic and Cardiovascular Surgery · doi:10.1053/j.semtcvs.2022.06.012 · Cited by 17
Percutaneous Left Atrial Appendage Closure With LACBES® Occluder ― A Preclinical Feasibility Study ―
Tang, X., Zhang, Z., Wang, F., Bai, Y., Xu, X., Huang, X., Zhao, X., Gong, S., & Qin, Y. (2017) · Circulation Journal · doi:10.1253/circj.cj-17-0412 · Cited by 17
Parikh, V. K., Bartuś, K., Litwinowicz, R. A., Turagam, M. K., Sadowski, J., Kapelak, B., Bartuś, M., Podolec, J., Brzeziński, M., Musat, D. L., et al. (2019) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14229 · Cited by 17
Atrial Fibrillation: Modern Concepts and Management
Agarwal, A., York, M., Kantharia, B. K., & Ezekowitz, M. D. (2004) · Annual Review of Medicine · doi:10.1146/annurev.med.56.082103.104656 · Cited by 17
Omran, H., Schmidt, H., Hardung, D., Hammerstingl, C., von der Recke, G., Haas, S., Büttner, R., & Lüderitz, B. (2005) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-005-3489-6 · Cited by 17
“Recently, a new interventional device has been introduced for occluding the left atrial appendage ‐ the most frequent location for thrombus formation potentially reducing the rate of embolism [ 4 ].”
BackgroundLeft Atrial Appendage Exclusion for Stroke Prevention in Atrial Fibrillation
Patel, T. K., Yancy, C. W., & Knight, B. P. (2012) · Cardiology Research and Practice · doi:10.1155/2012/610827 · Cited by 16
“A review of 23 studies found that thrombi were present in 17% of patients with nonrheumatic AF, of which 91% were located in the LAA [9].”
BackgroundJohnsrud, D. O., Melduni, R. M., Lahr, B. D., Yao, X., Greason, K. L., & Noseworthy, P. A. (2018) · Clinical Cardiology · doi:10.1002/clc.23066 · Cited by 16
Ghodrati-Misek, M., Schlöglhofer, T., Gross, C., Maurer, A. B., Zimpfer, D., Beitzke, D., Zonta, F., Moscato, F., Schima, H., & Aigner, P. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.1010862 · Cited by 16
“The left atrial appendage (LAA) has been considered as a potential source of thrombus formation for atrial fibrillation (AF) patients because of their reduced atrial contractility, which can lead to blood stasis and platelet deposition (Blackshear and Odell, 1996).”
BackgroundLeft atrial appendage structural characteristics predict thrombus formation
Castellani, C., Gao, Y., Kim, H., Thompson, C. D., Ning, J., Lohr, N. L., Welsh, A. C., & Berger, M. G. (2023) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.15994 · Cited by 16
Faletra, F. F., Ho, S. Y., Regoli, F. D., Aceña, M., & Auricchio, A. (2012) · Heart · doi:10.1136/heartjnl-2011-301336 · Cited by 16
Aytemir, K., Aminian, A., Asıl, S., Canpolat, U., Kaya, E. B., ŞAHINER, L., Evranos, B., Yorgun, H., & Özer, N. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.08.171 · Cited by 16
Atrial Fibrillation and Deterioration in Cognitive Function
Chinta, V., Askandar, S., Nanda, A. S., Sharma, A., Abader, P., Kabra, R., & Khouzam, R. N. (2018) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2018.07.001 · Cited by 16
van den Berg, N. W. E., Neefs, J., Berger, W. R., Boersma, L. V. A., van Boven, W. J., van Putte, B. P., Kaya, A., Kawasaki, M., Driessen, A. H. G., & de Groot, J. R. (2019) · Journal of Cardiovascular Medicine · doi:10.2459/jcm.0000000000000868 · Cited by 16
The History of the Left Atrial Appendage Occlusion
Holmes, D. R., & Alkhouli, M. A. (2020) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2019.11.009 · Cited by 16
He, J., Fu, Z., Yang, L., Liu, W., Tian, Y., Liu, Q., Jiang, Z., Tian, L., Huang, J., Tian, S., et al. (2020) · Clinical Cardiology · doi:10.1002/clc.23381 · Cited by 16
“The results of this study also showed that the course of AF among those patients in the thrombosis group was significantly longer than that in the non-thrombosis group [30 (1-180) months vs 22 (1-120) months, P < .”
ResultLeft atrial appendage size in patients with atrial fibrillation in Japan and the United States
Ono, S., Kubo, S., Maruo, T., Kar, S., & Kadota, K. (2020) · Heart and Vessels · doi:10.1007/s00380-020-01690-1 · Cited by 16
Ren, Z., Zhang, J., Wang, S., Jia, P., Li, X., Zhang, J., Guo, R., Li, H., Li, S., Yang, H., et al. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.610537 · Cited by 17
“As left atrial appendage (LAA) harbors 90% of thrombus non-valvular AF patients (7), LAA closure (LAAC) was invented to prevent stroke, and studies have validated its safety and efficacy compared to oral anticoagulants (OACs) (8).”
BackgroundQureshi, A., Darwish, O. I., Dillon-Murphy, D., Chubb, H., Williams, S. E., Nechipurenko, D. Y., Иноятович, А. Ф., Nordsletten, D., Aslanidi, O. V., & de Vecchi, A. (2020) · Computing in cardiology · doi:10.22489/cinc.2020.219 · Cited by 16
“Variable morphologies of the LAA make it prone to thrombogenesis and responsible for over 90% of AF-related thrombi [3].”
BackgroundResultInfluentialMohanty, S., Mohanty, P. K., Trivedi, C. G., Assadourian, J. N., Mayedo, A., MacDonald, B. C., Rocca, D. G. D., Gianni, C., Horton, R., Al‐Ahmad, A., et al. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.019664 · Cited by 17
Robotics-assisted epicardial left atrial appendage clip exclusion
Antaki, T., Michaelman, J., & McGroarty, J. (2021) · JTCVS Techniques · doi:10.1016/j.xjtc.2021.07.009 · Cited by 17
“3 The use of oral niques c Volume 9, Number C 59 Abbreviations and Acronyms AF ¼ atrial fibrillation CHA2DS2-VASc ¼ congestive heart failure, hypertension, age, diabetes, stroke, vascular disease score CTA ¼ computerized tomographic angiography DAPT ¼ dual antiplatelets therapy HAS-BLED ¼ hypertension, abnormal liver…”
Background
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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