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- Title
Use of a cutting stapler to excise a left atrial appendage in minimally invasive cardiac surgery.
- Authors
Orii, Mamoru; Hosoba, Soh; Tokoro, Masayoshi; Ozeki, Takahiro; Kato, Riku; Sawaki, Sadanari; Ito, Toshiaki
- Abstract
Purpose: A cutting stapler is a well-established instrument in many surgical fields. However, its efficacy and safety have not been proven yet in resecting a left atrial appendage (LAA) in minimally invasive cardiac surgery (MICS). Methods: A cutting stapler was used to resect the LAA in 98 consecutive patients who underwent MICS. Of these, 26 patients underwent aortic valve replacement, 72 mitral valve repair/replacement, 25 tricuspid annuloplasty, 7 closure of atrial septal defect, and 26 the Maze procedure (contains overlapping). The ascending aorta was elevated using a retractor, and a 12-mm shaft motor-driven cutting stapler was inserted through the transverse sinus. As a control group, 150 patients who underwent suture resection/closure of the LAA either from inside or outside were compared. Results: There was one mortality in each group. They were not related to the LAA resection/closure. In the suture group, the LAA suture was taken down in one patient because of a suspected obstruction of the circumflex artery, and two patients had re-exploration for bleeding from the LAA. In the stapler group, there was no complication related with the LAA. The rate of complication did not reach a statistical difference. Conclusion: A cutting stapler is considered to be a useful instrument to resect the LAA in MICS.
- Subjects
MINIMALLY invasive procedures; LEFT heart atrium; SURGICAL instruments; ATRIAL septal defects; AORTIC valve transplantation; STAPLERS (Surgery)
- Publication
Surgery Today, 2021, Vol 51, Issue 4, p520
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-020-02104-5