Donna Eaton
Mater Misericordiae University Hospital, Ireland
Title: Reducing stroke risk in patients with atrial fibrillation, minimally invasive clipping of the left atrial appendage: A case series report
Biography
Biography: Donna Eaton
Abstract
Introduction: There is a clear relationship between the left atrial appendage (LAA) and stroke in patients with non-valvular AF. Recently, device closure of the LAA has emerged as a safe and effective alternative to anti-coagulation for some patients. We present our experience of minimally invasive clipping of the LAA.
Results: We have performed thoracoscopic occlusion of the LAA using an epicardial clip (AtriClip) in 15 patients. LAA clipping was performed as a stand-alone procedure, a hybrid procedure (in combination with catheter based ablation), part of a totally thoracoscopic AF ablation procedure or as an adjuvant in patients undergoing left thoracoscopic operations (e.g. lobectomy, lung biopsy). The clip is deployed epicardially over the base of the LAA under direct vision, effectively and reproducibly occluding the LAA.
In all cases the clip achieved complete LAA exclusion. It can be easily deployed via a minimally invasive surgical approach requiring only a short (30-45 minute) general anesthetic. We have found minimally invasive LAA closure to be a safe, reliable and well-tolerated procedure.
Discussion: Unlike endocardial devices this method allows immediate cessation of anticoagulation medications, as the clip is placed epicardially there is no requirement for anticoagulation post deployment and no risk of complications related to device migration.