MiscellaneousRole of Left Atrial Appendage in Left Atrial Reservoir Function as Evaluated by Left Atrial Appendage Clamping During Cardiac Surgery
Section snippets
Study Subjects:
Subjects consisted of 8 patients who had undergone coronary artery bypass graft (CABG) surgery (6 men and 2 women, mean age 63 ± 7 years) and 7 patients with mitral regurgitation (MR) due to rupture of the chordae tendineae, and followed by mitral valve repair or prosthetic valve replacement (5 men and 2 women, mean age 65 ± 8 years). All patients were in normal sinus rhythm. The patients in the CABG group included 5 with 2-vessel disease and 3 with multivessel disease. None had MR more than
Baseline Characteristics Before LAA Clamping:
There were no significant differences in age, heart rate, systolic systemic blood pressure, or left ventricular percent ejection fraction (61 ± 8% vs 63 ± 6%) between the MR and CABG groups. The mean LA pressure was significantly higher in the MR group than in the CABG group. The maximal LAA area (4.0 ± 0.8 vs 1.9 ± 0.2 cm2, p <0.01) and, LA dimension and left ventricular end-diastolic dimension (5.4 ± 0.4 vs 4.8 ± 0.4 cm, p <0.05) were significantly greater in the MR group than in the CABG
Discussion
The LAA has a blind pouch shape, and its orifice opens to the LA main chamber between the pulmonary veins and the left ventricle. Because the LAA volume normally is about 30% of that of the entire LA volume,[10]the LAA is considered to play an important role in hemodynamic abnormalities between the left atrium and left ventricle. However, much attention has been given to the LAA because of its high susceptibility to blood stagnation and thrombosis, and as a source of systemic embolism due to
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