Postoperative Coagulation Changes in Patients after Epicardial Left Atrial Appendage Occlusion Varies Based on the Left Atrial Appendage Size
Jakub Batko,
Jakub Rusinek,
Artur Słomka,
Radosław Litwinowicz,
Marian Burysz,
Magdalena Bartuś,
Dhanunjaya R. Lakkireddy,
Randall J. Lee,
Joanna Natorska,
Michał Ząbczyk,
Bogusław Kapelak,
Krzysztof Bartuś
Affiliations
Jakub Batko
CAROL—Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Jakub Rusinek
CAROL—Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Artur Słomka
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland
Radosław Litwinowicz
CAROL—Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Marian Burysz
Department of Cardiac Surgery, Regional Specialist Hospital, 86-300 Grudziądz, Poland
Magdalena Bartuś
Department of Pharmacology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Dhanunjaya R. Lakkireddy
The Kansas City Heart Rhythm Institution and Research Foundation, HCA MIDWEST HEALTH, Second Floor, 5100 W 110th St, Overland Park, KS 66211, USA
Randall J. Lee
Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, CA 94158, USA
Joanna Natorska
Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Michał Ząbczyk
Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Bogusław Kapelak
Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Krzysztof Bartuś
Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
Left atrial appendage occlusion affects systemic coagulation parameters, leading to additional patient-related benefits. The aim of this study was to investigate the differences in coagulation factor changes 6 months after epicardial left atrial appendage occlusion in patients with different LAA morphometries. This is the first study to analyze these relationships in detail. A prospective study of 22 consecutive patients was performed. Plasminogen, fibrinogen, tPA concentration, PAI-1, TAFI and computed tomography angiograms were performed. Patients were divided into subgroups based on left atrial appendage body and orifice diameter enlargement. The results of blood tests at baseline and six-month follow-up were compared. In a population with normal LAA body size and normal orifice diameter size, a significant decrease in analyzed clotting factors was observed between baseline and follow-up for all parameters except plasminogen. A significant decrease between baseline and follow-up was observed with enlarged LAA body size in all parameters except TAFI, in which it was insignificant and plasminogen, in which a significant increase was observed. Occlusion of the left atrial appendage is beneficial for systemic coagulation. Patients with a small LAA may benefit more from LAA closure in terms of stabilizing their coagulation factors associated with potential thromboembolic events in the future.
