OBJECTIVE

To describe a new method of isolation of the left atrial appendage (LAA) and analyze immediate postoperative results after mitral valve surgery.

MATERIAL AND METHODS

A new method of LAA obliteration was used in 90 patients for the period from January 2018 to July 2019 in our department. LAA occlusion was performed during mitral valve (MV) repair in 59 patients, MV replacement complicated by left atrial thrombosis in 18 patients and aortic valve replacement with bioprosthesis and simultaneous MV repair in 13 patients. Effectiveness of obliteration was assessed intraoperatively using transesophageal echocardiography. In postoperative period, we performed transthoracic (n=90) and transesophageal (n=20) echocardiography. The method is issued by the RF patent 2019 (RU 2 691 437 C1).

RESULTS

All patients were discharged. There was not a single case of bleeding. No thromboembolic complications were observed in patients with paroxysmal or permanent atrial fibrillation in postoperative period. Postoperative echocardiography data confirmed effective LAA obliteration and no recanalization.

CONCLUSION

The proposed method of LAA obliteration ensures complete isolation of thrombogenic arrhythmogenic zone of the left atrium, increases the effectiveness of treatment and prevention of cardiogenic thrombosis and thromboembolism in early and mid-term postoperative period. A new method of LAA isolation can be used for MV surgery in patients with paroxysmal and permanent atrial fibrillation.