LAUSR

BACKGROUND Left atrial appendage closure (LAAC) reduces the risk of stroke in patients with atrial fibrillation (AF). LAAC can be made surgically from the inside of the left atrium or from the outside. Exclusion can also be performed with stapling/clipping devices from the outside. Despite the excellent interior view of appendage, those techniques are impossible to implement during minimally invasive mitral valve surgery through right-sided minithoracotomy. AIM To assess the effectiveness of surgical closure of the left atrial appendage from the inside during minimally invasive mitral valve surgery. METHODS From 2012 to 2017, 50 patients with mitral valve disease and AF underwent minimally invasive mitral valve surgery and LAAC. The appendage was sutured from the inside using continuous suture. After a median 1.6-year follow-up post-operation period, 19 patients were examined using transthoracic (TTE) and transesophageal echocardiography (TEE). TEE was performed to assess if appendage had been closed efficiently. If any leakage was suspected, cardiac computed tomography (CT) was performed. RESULTS Among 19 patients TEE was performed between 0.5 and 5 years after the surgery. One patient had not tolerated TEE. Minimal leakage was suspected in two cases. All 3 patients underwent the CT examination, which confirms the leakage in one case (1/19). CONCLUSIONS Surgical LAAC during minimally invasive mitral valve surgery through the right minithoracotomy is an effective technique with durable results.