Yes, We Can! Yes, We Should! Results of Percutaneous Laao Procedure Performed By a Cardiac Surgeon
Radoslaw Litwinowicz1, Grzegorz Filip1, Krzysztof Bartus1, Boguslaw Kapelak1, Marian Burysz2.
1Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, J, Kraków, Poland, 2Department of Cardiac Surgery, Regional Hospital in Grudziadz, Grudziadz, Poland.
BACKGROUND: In the last decade, it has been observed a dynamic development of interventional cardiology treatment of structural heart diseases which were previously mainly reserved for cardiac surgery. The number of percutaneous procedures is increasing every year, therefore the young generation of cardiac surgeons must master percutaneous techniques to be able to cooperate or compete with cardiologists in the field of modern cardiovascular treatment. Left atrial appendage occlusion (LAAO) procedures are currently one of the fastest-growing branches of interventional cardiology performed mostly by cardiologists.In this study, we report the safety, intraoperative complications, efficacy and mid-term clinical results of percutaneous LAAO procedure, including epicardial and endocardial approaches, performed only by cardiac surgeons
METHODS: Two hundred and twenty-three patients (223) with AF who underwent percutaneous LAAO (84 patients using endocardial devices and 139 patients using epicardial devices) were enrolled. All procedures were performed only by cardiac surgeons in two centers. The accumulated follow‐up period in the study population was 704 patient‐years.
RESULTS: The procedure was successful in 96.8% of cases. Procedural or device-related adverse events were noted in 9 cases (4.1%): four patients developed tamponade, four had access-related complications and there was one case of in-hospital sudden cardiac death. During the follow-up period, there were 26 (12.0%) deaths and 8 (3.7%) thromboembolic events including 3 cases of cerebrovascular accident, 3 cases of systemic thromboembolism and 2 cases of device-related thrombus.
CONCLUSIONS:Percutaneous LAAO procedures performed by cardiac surgeons can be performed effectively with acceptably low access complications and periprocedural adverse events compared with the results reported by cardiologists.