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. 2016 Jun 30;9(1):1407.
doi: 10.4022/jafib.1407. eCollection 2016 Jun-Jul.

Concomitant Left Atrial Appendage Clipping During Minimally Invasive Mitral Valve Surgery: Technically Feasible and Safe

Ashraf Alqaqa  1 , Shabiah Martin  2 , Aiman Hamdan  1 , Fayez Shamoon  1 , Kourosh T Asgarian  2
Affiliations

Concomitant Left Atrial Appendage Clipping During Minimally Invasive Mitral Valve Surgery: Technically Feasible and Safe

Ashraf Alqaqa et al. J Atr Fibrillation. .

Abstract

Background: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach.

Method: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®). The patient s' clinical characteristics, intraoperative complications, and in-hospital coarse were obtained by reviewing the medical records.

Result: Total of 22 patients(50% males) were included in the study. The median ages was 66.0 years (IQR: 50.8 to 81.3). Eight(36%) had mitral valve replacement and the rest had mitral repair surgery. Five(23%) patients needed blood product transfusion during the surgery. No clip related bleeding was observed and no perioperative mortality was recorded.

Conclusion: During minimally invasive mitral valve surgery, Concomitant exclusion of the left atrial appendage using AtriClip® can be performed rapidly and safely.

Keywords: Left Atrial Appendage; Mitral Valve Surgery; Transesophageal Echocardiogram.

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Figures

Figure 1
Figure 1. By mobilizing the ascending aorta, the base of the LAA can be visualized posterior to the aorta in the coronal junction of the transverse sinus. The atrial clip is advanced through the coronal junction of transverse sinus and placed over the base of the LAA
Figure 2
Figure 2. Once the clip is secured at the base and judged satisfactory by the primary surgeon, the LAA is clipped using appropriately sized clip
Figure 3A
Figure 3A. TEE image shows complete obliteration of the LAA post clipping ( Arrow)
Figure 3B
Figure 3B. TEE image shows no color flow across the LAA orifice post clipping (Arrow)
See this image and copyright information in PMC

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