Author + information
- Odunayo Olorunfemi,
- Ayman Elbadawi,
- Gbolahan Ogunbayo,
- Oladimeji Akinboro,
- Rebecca Ojo,
- Deola Saheed and
- Amole Ojo
Background: Left Atrial Appendage excision (LAA) is a commonly performed procedure in many patients with AF undergoing Coronary Artery Bypass Graft surgeries (CABG). Our study evaluates the thromboembolic outcomes of LAA excision in patients undergoing CABG.
Methods: We queried the Nationwide Inpatient Survey Database for the 16 year period from 1998 to 2013. Using ICD-9-CM diagnosis codes, we identified patients who had a diagnosis of AF and underwent a primary procedure of CABG with or without a LAA excision. We then matched all the patients based on their CHA2DS2VASc score – a validated stroke prediction score. We describe baseline characteristics and performed multivariate logistic regression analysis with stroke and transient ischemic attack (TIA) as primary outcomes and in-hospital mortality and length/cost of stay as secondary outcomes.
Results: Our analysis included 5619 patients with a diagnosis of AF who underwent an LAA excision with their CABG who were matched by CHA2VASC2 score with 5619 patients who underwent CABG without LAA excision. Mean age was 71.8 years 29.1% and of them were females. There was no difference in the length of hospital stay (10.7 vs 10.9 days, p=0.291), duration on intubation greater than 72 hours (6.0 %vs 6.4%, p=0.240), rates of pneumonia (3.1% vs 2.9%) between the CABG + Excision group and the CABG only group respectively. The CABG + LAA excision cohort however had more pericardial effusion rates (1.2% vs 0.4%; p<0.001) but no overall difference between two groups in major bleeding events (p=0.687). Multivariate regression analysis showed that CABG + Excision is associated with a higher cost of stay [t: 22.5; p<0.001] but no statistically significant increased association with occurrence of acute stroke [OR 1.35; p=0.253] or mortality [OR 0.83; p=0.312] as compared with patients undergoing CABG only.
Conclusions: In patients with atrial fibrillation undergoing CABG with or without LAA excision who were matched according to a validated stroke prediction score in a national database, there was no statistically significant difference in the rates of mortality or acute stroke in the CABG plus LAA excision group as compared with the CABG only group.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: AF Miscellaneous and Surgical Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1236-081
- 2017 American College of Cardiology Foundation