In patients with valvular heart disease and atrial fibrillation (AF) undergoing surgical valve surgery, current guidelines recommend concomitant surgical management of the left atrial appendage (LAA) to prevent postoperative thromboembolic events, particularly neurologic embolic events. However, whether concomitant LAA management benefits patients without AF by reducing postoperative neurologic complications remains controversial. Given these uncertainties, this study aims to evaluate whether concomitant LAA suture closure during surgical valve surgery is associated with a lower incidence of perioperative silent cerebral infarction.
Study Type
OBSERVATIONAL
Enrollment
100
Concomitant suture closure of the LAA performed at the time of surgical valve surgery, at the discretion of the operating surgeon.
Standard surgical valve repair or replacement performed according to routine clinical practice.
Fuwai Hospital Chinese Academy of Medical Sciences
Beijing, Beijing Municipality, China
Peking University First Hospita
Beijing, Beijing Municipality, China
Qingdao Cardiovascular Hospital
Qingdao, China
Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
Shenzhen, China
Silent brain infarction (SBI)
Occurrence of SBI assessed by postoperative brain magnetic resonance imaging (MRI) performed at approximately postoperative day 5.
Time frame: Approximately postoperative day 5
Perioperative stroke
Incidence of clinically overt stroke within 30 days after surgery.
Time frame: Within 30 days after surgery
Perioperative all-cause mortality
Death from any cause within 30 days after surgery.
Time frame: Within 30 days after surgery
Perioperative MACCE
Incidence of major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of stroke, myocardial infarction, all-cause death, or cardiovascular death occurring within 30 days after surgery.
Time frame: Within 30 days after surgery
Silent brain infarction (SBI) at 1 year
1 year after surgery
Time frame: Occurrence of SBI assessed by brain MRI at 1 year after surgery.
MACCE at 1 year
Incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 1 year after surgery, defined as a composite of stroke, myocardial infarction, all-cause death, cardiovascular death, or rehospitalization for heart failure.
Time frame: Within 1 year after surgery
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