The effect of the pericardial patching exclusion technique for left atrial appendage closure on postoperative reopening rate

Abstract

Background: The left atrial appendage (LAA) is the primary source of cardiogenic embolism in atrial fibrillation patients. Traditional LAA closure methods have shown suboptimal clinical outcomes. In recent years, some surgeons have proposed employing a autologous pericardial patch for suturing the LAA. Methods: This study included 104 patients undergoing mitral valve surgery with concomitant LAA closure at our center between January 2019 and December 2021. Two surgical methods for LAA closure were compared. A transesophageal echocardiogram performed 6 months after surgery was used to verify the success of left atrial appendage closure. Left atrial appendage closure failure was defined as reopening of the left atrial appendage or persistent blood flow into the left atrial appendage. Results: Among the 104 patients included (mean age: 65.0 ± 7.58 years, male: 52.50%), 7 patients were found to have a reopened left atrial appendage; 5 patients (5 of 32,15.6%) were in the suture closure group, and 2 patients (2 of 72,2.8%) were in the pericardial patch exclusion (PPE; defined as closure of the LAA orifice via sutured autologous pericardium) group (15.6% vs. 2.8%, P = 0.047). Conclusions: The pericardial patch exclusion technique is a reliable technique for closing the left atrial appendage in patients with atrial fibrillation and can effectively reduce the possibility of reopening the left atrial appendage.