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Subhasis Chatterjee, MD, John C. Alexander, MD, Paul J

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Presentation on theme: "Subhasis Chatterjee, MD, John C. Alexander, MD, Paul J"— Presentation transcript:

1 Left Atrial Appendage Occlusion: Lessons Learned From Surgical and Transcatheter Experiences 
Subhasis Chatterjee, MD, John C. Alexander, MD, Paul J. Pearson, MD, PhD, Ted Feldman, MD  The Annals of Thoracic Surgery  Volume 92, Issue 6, Pages (December 2011) DOI: /j.athoracsur Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Number of left atrial appendage publications in various periods from 1948 to 2011. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Surgical techniques of left atrial appendage (LAA) closure. (A) Epicardial suture exclusion. (B) Endocardial suture exclusion. (C) Stapled excision. (Left panel) Stapler positioned across the base of the LAA; (Right panel) LAA removed with intact stump. Studies suggest the residual stump may be too large. (D) Excision by removal and oversew. (Left panel) Lateral wall of the heart is elevated to bring the LAA into view; (Middle panel) Removal of the LAA by scissors (pictured) or electrocautery with a < 1 cm stump for closure; (Right panel) Two-layer suture closure of the LAA stump flush with the heart surface. (E) Transesophageal echocardiogram shows no flow after removal and oversew. (F) View from inside the left atrium after removal and oversew demonstrates complete closure. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 2 Surgical techniques of left atrial appendage (LAA) closure. (A) Epicardial suture exclusion. (B) Endocardial suture exclusion. (C) Stapled excision. (Left panel) Stapler positioned across the base of the LAA; (Right panel) LAA removed with intact stump. Studies suggest the residual stump may be too large. (D) Excision by removal and oversew. (Left panel) Lateral wall of the heart is elevated to bring the LAA into view; (Middle panel) Removal of the LAA by scissors (pictured) or electrocautery with a < 1 cm stump for closure; (Right panel) Two-layer suture closure of the LAA stump flush with the heart surface. (E) Transesophageal echocardiogram shows no flow after removal and oversew. (F) View from inside the left atrium after removal and oversew demonstrates complete closure. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 3 New left atrial appendage closure devices: (A) PLAATO, (B) Amplatzer Cardiac Plug, (C) Watchman, and (D) Lariat. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

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