Left atrial appendage (LAA) has been found to be associated with the occurrence of thromboembolism in patients with nonvalvular atrial fibrillation (NVAF). Stapling exclusion of LAA during surgical ablation could be an alternative to oral anticoagulation for NVAF patients. However, its safety and efficacy have rarely been examined. Thus, in this study, we aimed to evaluate the safety and efficacy of a powered surgical stapler for LAA resection during ablation for patients with NVAF.

Adult patients with NVAF undergoing stapler surgery were included in this study. LAAs of patients were cut off using a powered surgical stapler. Intraoperative transesophageal echocardiogram (TEE) was applied before and after the operation. Each patient received anticoagulant therapy for 2 months after surgery and was regularly followed up by appointment or via telephone call. Patients would undergo physical examinations, echocardiography, and 24-hour dynamic electrocardiogram in a local or in our hospital to determine whether there was a recurrence of atrial fibrillation (AF) or thromboembolism caused by AF.

In total, 124 patients were included in this study (male: 88 (71.0%); mean age: 62.3 years). Blood loss was less than 100 mL in all patients with no operative complications or hospital deaths. Moreover, 119 (96.0%) follow-up data were collected, with a mean period of 27.4 months. All patients discontinued oral anticoagulants 2 months after their operation. As per our findings, AF recurred in 23 patients (18.5%), with an average of 9.1 months after surgery. No patients were diagnosed with thromboembolism related to AF.

Stapling exclusion of LAA during surgical ablation could safely and completely resect the LAA. The effect of thrombus prevention was deemed satisfactory.

已发现左心耳 (LAA) 与非瓣膜性心房颤动 (NVAF) 患者血栓栓塞的发生有关。在手术消融期间缝合排除 LAA 可能是 NVAF 患者口服抗凝治疗的替代方案。然而，其安全性和有效性很少被研究。因此，在本研究中，我们旨在评估电动手术吻合器在 NVAF 患者消融期间用于 LAA 切除的安全性和有效性。

本研究包括接受吻合器手术的成年 NVAF 患者。使用电动外科缝合器切断患者的 LAA。术中经食管超声心动图（TEE）在手术前后应用。每位患者术后均接受抗凝治疗 2 个月，并定期接受预约或电话随访。患者将在当地或我院进行体格检查、超声心动图和24小时动态心电图检查，以确定是否有房颤复发或房颤引起的血栓栓塞。

本研究共纳入 124 名患者（男性：88 名（71.0%）；平均年龄：62.3 岁）。所有患者的失血量均小于 100 mL，无手术并发症或住院死亡。此外，还收集了 119 (96.0%) 次随访数据，平均时间为 27.4 个月。所有患者在术后 2 个月停用口服抗凝剂。根据我们的研究结果，房颤在 23 名患者 (18.5%) 中复发，平均术后 9.1 个月。没有患者被诊断出与 AF 相关的血栓栓塞。

在手术消融期间缝合排除左心耳可以安全和完全地切除左心耳。认为预防血栓的效果令人满意。