Circulation reports · 2026
Outcomes of Thoracoscopic Left Atrial Appendage Occlusion With or Without Concomitant Thoracoscopic Ablation - Multicenter Retrospective Registry of 567 Patients in Japan.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nakayama Taisuke, Ito Hiroshi, Sato Shunsuke, Kure Seimei, Hama Gentaku, Aoki Masakazu, Takahashi Shinya
Аннотация
BACKGROUND: Atrial fibrillation (AF) is a major risk factor for ischemic stroke, with >90% of thrombi in nonvalvular AF originating in the left atrial appendage (LAA). Thoracoscopic LAA occlusion (LAAO), with or without ablation, is a minimally invasive alternative to endocardial devices or anticoagulation, but multicenter data are limited.
METHODS AND RESULTS: The Totally Thoracoscopic Left Atrial Appendage Occlusion Study (TT-LAAOS) is a multicenter Japanese registry of thoracoscopic LAAO in nonvalvular AF. From March 2018 to December 2024, 567 patients underwent the procedure at 6 institutions using stapler excision or epicardial clip. Outcomes included procedural success, anatomic closure, cerebrovascular events, and anticoagulant withdrawal. Mean age was 72 years; 63.5% had long-standing persistent AF. Median CHADS2 and CHA2DS2 VASc scores were 2 and 4, respectively. Success was 99.8% with no intraoperative deaths; residual stumps >10 mm were found in 1.5%. At discharge, sinus rhythm was present in 45%. Anticoagulants were stopped in 15% immediately and 63% within 1 month. During 875.8 patient years of follow-up (median 13 months), freedom from stroke or transient ischemic attack was 99.5% (0.34/100 patient years), with no thromboembolic deaths.
CONCLUSIONS: Thoracoscopic LAAO, with or without ablation, is safe and effective for stroke prevention in AF, with high success, reliable closure, and very low midterm events.
METHODS AND RESULTS: The Totally Thoracoscopic Left Atrial Appendage Occlusion Study (TT-LAAOS) is a multicenter Japanese registry of thoracoscopic LAAO in nonvalvular AF. From March 2018 to December 2024, 567 patients underwent the procedure at 6 institutions using stapler excision or epicardial clip. Outcomes included procedural success, anatomic closure, cerebrovascular events, and anticoagulant withdrawal. Mean age was 72 years; 63.5% had long-standing persistent AF. Median CHADS2 and CHA2DS2 VASc scores were 2 and 4, respectively. Success was 99.8% with no intraoperative deaths; residual stumps >10 mm were found in 1.5%. At discharge, sinus rhythm was present in 45%. Anticoagulants were stopped in 15% immediately and 63% within 1 month. During 875.8 patient years of follow-up (median 13 months), freedom from stroke or transient ischemic attack was 99.5% (0.34/100 patient years), with no thromboembolic deaths.
CONCLUSIONS: Thoracoscopic LAAO, with or without ablation, is safe and effective for stroke prevention in AF, with high success, reliable closure, and very low midterm events.