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”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [273]
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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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