Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients With Elevated CHADS-VASc Score: Results of the Randomized ATLAS Trial.

Objective: Patients with elevated CHADS-VASc scores are at high risk for atrial fibrillation (AF) and thromboembolic events (TE) after cardiac surgery. Left atrial appendage exclusion (LAAE) is a permanent, continuous approach to stroke prevention in AF, overcoming limitations of oral anticoagulation (OAC). We report ATLAS trial results focused on LAAE technical success and perioperative safety and TE rates with and without LAAE in cardiac surgery patients who developed postoperative AF (POAF).

The pneumatic tourniquet technique for endoscopic radial artery harvest.

Background: Endoscopic vessel harvest is viewed as a safe, reliable, and cost-effective method for greater saphenous vein removal. As the radial artery has more recently become a popular conduit choice in coronary artery revascularization, we describe herein an endoscopic technique for radial artery harvest in our first 50 patients as an alternative to the more traditional open technique.

Methods: From November 2001 to July 2002, 54 radial arteries were harvested endoscopically in 50 patients utilizing the VasoView Endoscopic Vessel Harvesting System, an Esmark bandage, and a pneumatic cuff tourniquet.

Stroke and atrial fibrillation following cardiac surgery.

Objective: Stroke is an occasional devastating complication of cardiac surgery. Transient atrial fibrillation (AF) is a frequent complication of cardiac surgery. Emboli originating from the fibrillating left atrium are a known cause of stroke in the non-surgical setting.