Left atrial appendage occlusion procedures

Atrial fibrillation (AF) is the most common cardiac dysrhythmia encountered by cardiac surgeons in their practice. The incidence of AF rises with age from approximately 0.1% in adults younger than 55 to 9% in individuals older than 80. The routine performance of detailed examinations before cardiac surgery entails that, in most cases, AF patients are receiving treatment; however, there are still patients who remain undiagnosed and unaware of the disease due to the lack of symptoms [1–3].
Atrial fibrillation is associated with a manifold increase in the risk of ischemic stroke. It also significantly increases the incidence of serious conditions, such as congestive heart failure, premature death, or thromboembolic complications. Therefore, we should all strive to treat AF in our patients and prevent the occurrence of associated complications [4, 5].
The most common treatment for AF patients which can be employed by any physician is currently oral anticoagulation (OAC). The principles of OAC use in AF patients are discussed in detail in recommendations issued by scientific associations.
The guidelines of the European Society of Cardiology (ESC) recommend that all patients diagnosed with AF should be assessed with regard to the risk of thromboembolic complications using the CHA2DS2-VASc scale; patients with scores of 1 or more should undergo effective stroke prevention, mostly in the form of OAC, which necessitates the evaluation of its effectiveness and safety with regard to the risk of hemorrhagic complications. A relatively precise assessment of this risk can be accomplished by using the HAS-BLED scale.
Considering the numerous possible contraindications for OAC, medication intolerance, and potential complications during OAC, this type of prevention cannot be successfully employed in all AF patients, as the risk of complications often exceeds the potential benefits of OAC.
Physicians have always searched for new treatments for their patients, including those in whom the current therapies are unsuccessful or cannot be used for various reasons. One of the methods for safeguarding patients from complications caused by AF, including ischemic stroke, has led to the strategy of performing left atrial appendage (LAA) occlusion.
The LAA occlusion (LAAO) has been associated with cardiac surgery procedures from its very inception. Initially, the procedures consisted in suturing the LAA during mitral commissurotomy, later also during...


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