title: Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study.
abstract: BACKGROUND
  In order to reduce stroke risk, left atrial appendage amputation (LAAA) is widely adopted in recent years. The effect of LAAA on left atrial (LA) function remains unknown. The objective of present study was to assess the effect of LAAA on LA function.
  
  
  METHODS
  Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group), and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group). To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up.
  
  
  RESULTS
  Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005). In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups.
  
  
  CONCLUSIONS
  In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.
authors.affiliation: Department of Cardio-Thoracic Surgery, University Medical Center Groningen, 9711 RB Groningen, Netherlands ; Department of Cardiology, University Medical Center Groningen, 9711 RB Groningen, Netherlands.
authors.forename: Gijs E
authors.initials: GE
authors.lastname: De Maat
authors.affiliation: Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Benussi
authors.affiliation: Department of Cardiology, University Medical Center Groningen, 9711 RB Groningen, Netherlands.
authors.forename: Yoran M
authors.initials: YM
authors.lastname: Hummel
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Krul
authors.affiliation: Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pozzoli
authors.affiliation: Department of Cardio-Thoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Antoine H G
authors.initials: AH
authors.lastname: Driessen
authors.affiliation: Department of Cardio-Thoracic Surgery, University Medical Center Groningen, 9711 RB Groningen, Netherlands.
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Mariani
authors.affiliation: Department of Cardiology, University Medical Center Groningen, 9711 RB Groningen, Netherlands.
authors.forename: Isabelle C
authors.initials: IC
authors.lastname: Van Gelder
authors.affiliation: Department of Cardio-Thoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Wim-Jan
authors.initials: WJ
authors.lastname: Van Boven
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Joris R
authors.initials: JR
authors.lastname: de Groot
mesh_terms: D000328:Adult; D000368:Aged; D020517:Atrial Appendage / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left / Q000502:physiology; D006348:Cardiac Surgical Procedures; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects