title: [Total Endoscopic Left Atrial Appendectomy for Valvular Atrial Fibrillation;Report of a Case].
abstract: Total endoscopic left atrial appendectomy for non-valvular atrial fibrillation(Af) has been reported to be a safe and effective procedure to prevent cardiogenic thromboembolism and also discontinue oral anticoagulant therapy. On the other hand, open-heart surgery is generally indicated for valvular Af. We report the case of a 67-year-old male patient with valvular Af and recurrent episodes of cardiogenic thromboembolism who underwent total endoscopic left atrial appendectomy. He was diagnosed as having mitral valve stenosis and scheduled for surgery, but presented with cerebellar hemorrhage after warfarin was replaced with heparin in the preoperative phase. Consequently, the operation was cancelled. The case was considered as a good relative indication for total endoscopic left atrial appendectomy, which does not need a cardiopulmonary bypass, to prevent future cardiogenic thromboembolism. The operation was performed and the postoperative course was uneventful.
authors.affiliation: Department of Cardiovascalar Surgery, Tsukuba Memorial Hospital, Tsukuba, Japan.
authors.forename: Kanan
authors.initials: K
authors.lastname: Kurahashi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Inoue
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshimoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Fujisaki
authors.forename: Sei
authors.initials: S
authors.lastname: Morisumi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Suematsu
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D001062:Appendectomy; D001281:Atrial Fibrillation / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D004724:Endoscopy; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging*
chemical_list: D000925:Anticoagulants; D006493:Heparin