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Left atrial appendage ligation - becoming the norm in CABG?

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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?

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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.

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