American Heart Journal
Volume 150, Issue 2 , Pages 288-293 , August 2005

Left Atrial Appendage Occlusion Study (LAAOS): Results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke

  • Jeff S. Healey, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • Corresponding Author InformationReprint requests: Jeff Healey, MD, McMaster University–General Site, 237 Barton St. East, Hamilton, Ontario, Canada L8L 2X2.
    • ,
  • Eugene Crystal, MD

      Affiliations

    • University of Toronto, Toronto, Ontario, Canada
    • ,
  • Andre Lamy, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Kevin Teoh, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Lloyd Semelhago, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Stefan H. Hohnloser, MD

      Affiliations

    • J. W. Goethe University, Frankfurt, Germany
    • ,
  • Irene Cybulsky, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Labib Abouzahr, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Corey Sawchuck, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Sandra Carroll, BSc

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Carlos Morillo, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Peter Kleine, MD

      Affiliations

    • J. W. Goethe University, Frankfurt, Germany
    • ,
  • Victor Chu, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Eva Lonn, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Stuart J. Connolly, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada

Received 9 May 2004 ,Accepted 20 September 2004.

References 

  1. Hart RG. Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med. 1999;131:492–501
  2. Goldstein LB, et al. Primary prevention of ischemic stroke: a statement for healthcare professionals from the stroke council of the American Heart Association. Stroke. 2001;32:280–299
  3. Wolf PA, Abbot RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham study. Stroke. 1991;22:983–988
  4. Connolly SJ, Cybulsky I, Lamy A, et al. Double-blind, placebo-controlled, randomised trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: the beta-Blocker Length Of Stay (BLOS) study. Am Heart J. 2003;145:226–232
  5. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61:755–759
  6. Crystal E, Lamy A, Connolly SJ, et al. Left Atrial Appendage Occlusion Study (LAAOS): a randomised clinical trial of left atrial appendage occlusion during routine coronary artery bypass graft surgery for long-term stroke prevention. Am Heart J. 2003;145:174–178
  7. Jones WJ, Williams LS, Meschia JF. Validating the questionnaire for verifying stroke-free status (QVSFS) by neurologic history and examination. Stroke. 2001;32:2232–2236
  8. Garcia-Fernandez MA, Perez-David E, Quiles J, et al. Role of left atrial appendage obliteration in stroke reduction in patients with mitral valve prosthesis. J Am Coll Cardiol. 2003;42:1253–1258
  9. Blackshear JL, Johnson WD, Odell JA, et al. Thoracoscopic extracardiac obliteration of the left atrial appendage for stroke risk reduction in atrial fibrillation. J Am Coll Cardiol. 2003;42:1249–1252
  10. Juratli N, Wilkoff BL, Tchou P, et al. Left atrial appendage ligation during mitral valve surgery may increase the risk of late thromboembolic events. J Am Coll Cardiol. 2002;39:85A
  11. Yoshihara F, et al. Atrial natriuretic peptide secretion and body fluid balance after bilateral atrial appendectomy by the maze procedure. J Thorac Cardiovasc Surg. 1998;116:213–219
  12. Al-Saady NM, Obel OA, Camm AJ. Left atrial appendage: structure, function and role in thromboembolism. Heart. 1999;82:547–554
  13. Yoshihara F, et al. Preservation of right atrial appendage improves reduced plasma atrial natriuretic peptide levels after the maze procedure. J Thorac Cardiovasc Surg. 2000;119:790–794
  14. Katz ES, Tsiamtsiouris T, Applebaum RM. Surgical left atrial appendage ligation is frequently incomplete: a transesophageal echocardiographic study. J Am Coll Cardiol. 2000;36:468–471

 Dr. Healey is supported by a research fellowship grant from the Heart and Stroke Foundation of Canada and Astra Zeneca Canada Ltd.

PII: S0002-8703(05)00021-9

doi: 10.1016/j.ahj.2004.09.054

American Heart Journal
Volume 150, Issue 2 , Pages 288-293 , August 2005

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