Elimination of the left atrial appendage to prevent stroke or embolism? Anatomic, physiologic, and pathophysiologic considerations.

Abstract:

:The "elimination" of the left atrial appendage (LAA) seems to be an attractive alternative to oral anticoagulation in the treatment of atrial fibrillation, especially in patients with contraindications to oral anticoagulation therapy. The LAA, however, plays an important role in the maintenance and regulation of the cardiac function, in arterial hypertension, atrial fibrillation, coronary heart disease, valvular heart disease, and heart failure. Data, mainly from animal studies, indicate that elimination of the LAA may impede thirst in patients with hypovolemia, may impair hemodynamic response to volume or pressure overload, may decrease cardiac output, and may promote heart failure. It may have adverse effects in humans as well. Further studies on the hemodynamic and neurohumoral consequences of left atrial appendage elimination are required to advance our understanding of LAA physiology and pathophysiology.

journal_name

Chest

journal_title

Chest

authors

Stöllberger C,Schneider B,Finsterer J

doi

10.1378/chest.124.6.2356

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

2356-62

issue

6

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)31698-6

journal_volume

124

pub_type

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