The relationship between incomplete surgical obliteration of the left atrial appendage and thromboembolic events after mitral valve surgery (from the ISOLATE Registry)

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dc.authorwosidKalkan, Mehmet Emin / ABH-7737-2020
dc.contributor.authorGüner, Ahmet
dc.contributor.authorKalçık, Macit
dc.contributor.authorGündüz, Sabahattin
dc.contributor.authorGürsoy, Mustafa Ozan
dc.contributor.authorGültekin Güner, Ezgi
dc.contributor.authorUlutaş, Ahmet Emir
dc.contributor.authorÖzkan, Mehmet
dc.date.accessioned2021-11-01T15:06:13Z
dc.date.available2021-11-01T15:06:13Z
dc.date.issued2021
dc.departmentHitit Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü
dc.description.abstractLeft atrial appendage (LAA) is a common site of thrombus formation especially in patients with atrial fibrillation (AF). Complete surgical LAA closure (cSLC) is the surgical aim, however incomplete surgical LAA closure (iSLC) is not rare. In this study, we aimed to evaluate the risk of thromboembolic complications (TEC) in AF patients with iSLC after mitral valve surgery. A total of 101 AF patients (mean age: 61.8 +/- 11.8 years; male:32), who underwent surgical suture ligation during mitral valve surgery were enrolled in this retrospective study. All patients underwent transthoracic and transesophageal echocardiography (TEE) at least 3 months after surgery. The primary outcome was the occurrence of TEC including any ischemic stroke, transient ischemic attack, coronary or peripheral embolism. TEE examination revealed cSLC in 66 (65.3%) and iSLC in 35 patients (34.6%). A total of 12 TECs (11.9%) occurred during a mean follow-up time of 41.1 +/- 15.6 months. TECs were found to be significantly higher in the iSLC group (25.7% vs 4.5%, p = 0.002). The prevalence of iSLC was significantly higher in patients with TEC (75 vs. 29.2%, p = 0.002). High CHA(2)DS(2)-VASc Score and iSLC were found to be independent predictors of TEC. Long term TEC free survival was found to be significantly decreased in patients with iSLC. The presence of iSLC was associated with a significantly increased risk of TEC in AF patients after mitral valve surgery. Routine intraoperative and postoperative screening for iSLC by TEE and long-term strict anticoagulation therapy are recommended in these patients.
dc.identifier.citationGüner, A., Kalçık, M., Gündüz, S., Gürsoy, M. O., Güner, E. G., Ulutaş, A. E., ... & Özkan, M. (2021). The relationship between incomplete surgical obliteration of the left atrial appendage and thromboembolic events after mitral valve surgery (from the ISOLATE Registry). Journal of Thrombosis and Thrombolysis, 51(4), 1078-1089.
dc.identifier.doi10.1007/s11239-020-02291-5
dc.identifier.endpage1089en_US
dc.identifier.issn0929-5305
dc.identifier.issn1573-742X
dc.identifier.issue4en_US
dc.identifier.pmid32997332
dc.identifier.scopus2-s2.0-85091732272
dc.identifier.scopusqualityQ1
dc.identifier.startpage1078en_US
dc.identifier.urihttps://doi.org/10.1007/s11239-020-02291-5
dc.identifier.urihttps://hdl.handle.net/11491/7518
dc.identifier.volume51en_US
dc.identifier.wosWOS:000574147300001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorKalçık, Macit
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofJournal Of Thrombosis And Thrombolysis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectLeft Atrial Appendageen_US
dc.subjectSurgical Ligationen_US
dc.subjectAtrial Fibrillationen_US
dc.subjectThromboembolismen_US
dc.titleThe relationship between incomplete surgical obliteration of the left atrial appendage and thromboembolic events after mitral valve surgery (from the ISOLATE Registry)
dc.typeArticle

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