Left Atrial Appendage Patency at Cardioversion After Surgical Left Atrial Appendage Intervention

The authors retrospectively reviewed the postoperative TEEs on patients undergoing DCCV within 30 days after cardiac surgery that included LAA closure (n=93 patients).  The presence of a residual communication between the LAA and the left atrium was 37% overall.  The LAA patency rates according to LAA technique were as follows:  amputation, 0%; suture closure, 51%; staple exclusion, 29%.  These results beg the question:  should the appendage always be amputated?