bike mike Posted November 24, 2010 Share Posted November 24, 2010 As a pre-PA who works in cardiac rehab I have noticed many more of our CABG patients are having left atrial appendage ligation as a part of their CABG surgery. I realize that these patients frequently have post-op Afib but it seems like there are a lot more having the LAA ligation proceedure recently. Anyone know if this is becoming more of the norm for CABG pts? Link to comment Share on other sites More sharing options...
andersenpa Posted November 24, 2010 Share Posted November 24, 2010 It's not an endorsed standard...more of a personal surgeon-to-surgeon preference. Interestingly CABG patients are the lower risk group for appendage thromboemboli. Mitral valve patient typically have the highest risk. Most LA clots reside in the LAA, but the incidence is low, even in those with preoperative AF. There are some arguments against closing the appendage, in relation to atrial function, secretion of ANP, and technical issues (failure to close if not completely excised, bleeding risk, post-removal thrombosis). As far as I have seen prophylactic removal of the LAA for postop AF is not recommended. Link to comment Share on other sites More sharing options...
bike mike Posted November 28, 2010 Author Share Posted November 28, 2010 Thanks for the info Andersen - I didn't know that it was the mitral valve patients who are higher risk for throwing a clot. Link to comment Share on other sites More sharing options...
merseur Posted August 24, 2015 Share Posted August 24, 2015 We only ligate the LAA with CABG if the patient has history of a fib. Although it's very seldom. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 24, 2015 Moderator Share Posted August 24, 2015 the mother of a close friend just had the "lariat procedure" endoscopically and had every complication you can imagine including intraoperative cva... Link to comment Share on other sites More sharing options...
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