Ligation of Left Atrial Appendage during Off-Pump Coronary Surgery.

Objective: The main purpose of this article is to evaluate an impact of epicardial ligation of the left atrial appendage (LAA) in patients with atrial fibrillation (AF) undergoing off-pump coronary artery bypass grafting (OPCAB) on the development of ischemic stroke and mortality.

Methods: From 2009 to 2013, a total of 125 patients (86.4% men, mean age 64 ± 7 years, 95% confidence interval: 61-65 years) received a combined OPCAB and LAA ligation because of coronary artery disease and AF. All the subjects were divided into two groups: group 1 ( = 57)-LAA ligation during OPCAB, group 2 ( = 68) without LAA ligation during OPCAB. Primary endpoints were postoperative incidence of ischemic stroke and mortality.

Results: No difference in the number of ischemic stroke (0 vs. 5.9%) and death (0 vs. 4.4%) in both groups during the hospital period ( > 0.05). Median overall follow-up was 41 (22-61) months: without difference for groups ( > 0.05). During follow-up, there was a difference in the number of ischemic stroke (0 vs. 17.6%,  < 0.001), while there was no difference in mortality in two study groups (5.3 vs. 16.2%,  > 0.05).

Conclusion: Epicardial ligation of LAA during OPCAB in patients with AF may reduce the risk of ischemic stroke in long-term follow-up and does not affect the mortality.