Results of the Novel Tourniquet Technique Left Atrial Appendage Ligation

Pavel A. Shilenko, Yurii A. Schneider, Men-De Tsoi, Andrei S. Kotcienko

FGBU FCHMT, Kaliningrad, Russia

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – A

Abstract

Objective: The left atrial appendage (LAA) has been identified as a common site of thrombus formation in patients with atrial fibrillation (AF).Ligation of the LAA to prevent future thromboembolic events. Effective method of stroke prevention is exclusion left atrial appendage. This research shows results efficiency of the novel tourniquet technique left atrial appendage ligation as the stage of thoracoscopic ablation operations.

Methods: from December 2016 to October 2017 in 53 patients with AF, for exclude left atrial appendage, we have made thoracoscopic tourniquet left atrial appendage ligation.The average age was61.5 years (35-77 years). 50 had long-standing persistent AF. Seven people had a prior stroke. The average volume left atrium was 148.6 ml. 10 operations were performed using one ligature. In 43 cases, two ligatures were applied. Ligation was carried out under the TEE control. After the operation, a series of CT were performed.

Results: there were no lethal outcomes, bleeding, and stroke. In the group with one ligation, in three cases an incomplete left atrial appendage ligation was detected. In the group with two ligatures, the left atrial appendage was not contrasted. In one case, a residual stump of 8 mm in length was detected.

The average time of left atrial appendage ligation was 15 minutes. After 3 months, a morphological picture has not changed in any patient, according CT results.

Conclusions: a new method for excluding the left atrial appendage showed high safety with an efficiency 96.5%. This technique is applicable to various methods of minimally invasive surgery, not too hard to apply.