Evidence map›Paper›PMID 39994517›Full record

ArticleBMC cardiovascular disorders2025

The efficiency of endocardial suture occlusion of the left atrial appendage at a single institution: MICs vs. sternotomy.

Chengfeng Huang, Jiawen Huang, Si Shen, Yongheng Li, Yanlin Zhang, Xiaoshen Zhang, Hua Lu

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Chengfeng Huang *Department of Cardiovascular Surgery, The First Affiliated Hospital, Jinan University, 613 Whampoa Avenue, Tianhe District, Guangzhou, 510630, China.
Jiawen Huang *Department of Pharmacy, The First Affiliated Hospital, Jinan University, Guangzhou, China.
Si Shen *Department of Radiology, Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, China.
Yongheng LiSchool of Medicine, Jinan University, Guangzhou, China.
Yanlin ZhangDepartment of Cardiovascular Surgery, The First Affiliated Hospital, Jinan University, 613 Whampoa Avenue, Tianhe District, Guangzhou, 510630, China.
Xiaoshen ZhangDepartment of Cardiovascular Surgery, The First Affiliated Hospital, Jinan University, 613 Whampoa Avenue, Tianhe District, Guangzhou, 510630, China. xsh.zhang@hotmail.com.
Hua Lu *Department of Cardiovascular Surgery, The First Affiliated Hospital, Jinan University, 613 Whampoa Avenue, Tianhe District, Guangzhou, 510630, China. specialhual@icloud.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost thrombi originate from the left atrial appendage (LAA), preventing thromboembolic stroke is an important aspect of stroke prevention. Previous studies have found that LAA closure is beneficial for preventing thrombosis. Currently, surgical procedures can achieve LAA closure by closing the endocardium or epicardium. LAA endocardial suture technique is performed concomitantly during sternotomy cardiac surgery but can also be performed during right minimally invasive cardiac surgery (MICS).

aimsThis study aims to evaluate the efficacy of left atrial appendage closure (LAAC) with MICS.

methodsA total number of 74 patients who underwent LAAC during valve operation between 2017 and 2021 were retrospectively analyzed in this study. LAA was closed by continuous suture through the endocardium of the left atrium during cardiac surgery. 42 patients performed LAA endocardial suture during MICS, while 32 patients performed with the same LAAC technique during sternotomy. Patients underwent cardiac computed tomography (CT) follow-up after surgery to verify the completeness of the LAAC. The heart structure and function were recorded by echocardiography Transthoracic echocardiography (TTE), and the heart rhythm was recorded by electrocardiogram.

resultsThe LAA closure procedure was successful in 26 cases (81%) in the sternotomy group and 20 cases (48%) in the right minimally invasive group. Residual shunting (failed LAA closure) was more common in the right minimally invasive group (p = 0.003), and no correlation was found between residual shunting and left atrial (LA), left ventricular end-diastolic diameter (LVDD), and left ventricular ejection fraction (LVEF). The incidence of leaks was not associated with mitral valve replacement or valvuloplasty.

conclusionsCompared to sternotomy, residual shunting after MICS was more common. CT imaging analysis of 22 patients with failed closure in the MICS group showed that residual shunting was mainly concentrated on margins of the suture (anterior superior and posterior inferior) (86%), with a middle area accounting for 3 (14%). Based on this finding, reinforcing the suture margins may significantly reduce the incidence of incomplete closure. THE CLINICAL TRIAL NUMBER: KY-2023-001.

Indexed as

Atrial AppendageCardiac Surgical ProceduresMinimally Invasive Surgical ProceduresSternotomySuture TechniquesAgedAtrial Function, LeftFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsTreatment OutcomeCardiac computed tomographyEndocardial suture occlusionLeft atrial appendage closureLeft atrial appendage patencyMinimally invasive cardiac surgery

Identifiers

PMID39994517
PMCPMC11849280

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