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. 2025 Aug 4;14(15):5473.
doi: 10.3390/jcm14155473.

Long-Term Follow-Up of Left Atrial Appendage Exclusion: Results of the V-CLIP Multi-Center Post-Market Study

Elias Zias  1 , Katherine G Phillips  1 , Marc Gerdisch  2 , Scott Johnson  3 , Ahmed El-Eshmawi  4 , Kenneth Saum  5 , Michael Moront  6 , Michael Kasten  7 , Chanderdeep Singh  8 , Gautam Bhatia  9 , Hiroo Takayama  10 , Ralph Damiano  11
Affiliations

Long-Term Follow-Up of Left Atrial Appendage Exclusion: Results of the V-CLIP Multi-Center Post-Market Study

Elias Zias et al. J Clin Med. .

Abstract

Background: Cardiac surgery patients with pre- or post-operative atrial fibrillation are at an increased risk for thromboembolic stroke, often due left atrial appendage (LAA) thrombus. Surgical LAA exclusion (LAAE) can be performed and must be complete to avoid increased thrombus formation. Methods: This prospective, multi-center, post-market study (NCT05101993) evaluated the long-term safety and performance of the epicardial V-shape AtriClip device. Patients ≥18 years who had received V-shape AtriClip devices during non-emergent cardiac surgery consented to a prospective 12-month follow-up visit and LAA imaging. The primary performance was LAAE without residual left atrium-LAA communication, assessed by imaging at the last follow-up visit. The primary safety was device- or implant procedure-related serious adverse events (SAEs) (death, major bleeding, surgical site infection, pericardial effusion requiring intervention, myocardial infarction) within 30 days. Results: Of 155 patients from 11 U.S. centers, 151 patients had evaluable imaging. Complete LAAE was obtained in all patients. Primary performance in the intent-to-treat population was met, with 97% (95% CI 93.52%, 99.29%; p = 0.0001) complete LAAE. Primary safety was met, with 100% (95% CI 97.75%, 100%; p < 0.0001) of patients free from pre-defined SAEs within 30 days. One device-related SAE was reported, which resolved intraprocedurally. Conclusions: AtriClip V-Clip showed safe and successful LAAE through 12 months of follow-up.

Keywords: AtriClip; cardiac surgery; left atrial appendage.

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Conflict of interest statement

Dr. Zias: AtriCure: consultant; Dr. Gerdisch: AtriCure: consultant, research; Artivion: consultant, research; Arthrex: consultant; Abbott: consultant; Corvivo: consultant, research; DASI Simulations: consultant, research; PleuraFlow: consultant; Dr. Moront: Medtronic Heart Valves: consultant and trainer; AtriCure: consultant and trainer; Haemonetics: lecturer; Dr. Johnson: AtriCure: speaker; Dr. El-Eshmawi: None; Dr. Bhatia: Baxter: consultant; Dr. Kasten: AtriCure: consultant; Dr. Saum: AtriCure: proctor, consultant; Dr. Takayama: Artivion: consultant; Edwards: consultant; Dr. Singh: None; Dr. Damiano: Edwards: consultant; Medtronic: consultant; AtriCure: speaker, research.

Figures

Figure 1
Figure 1
The AtriClip PROV (A) and FLEX-V (B) devices. The PROV and FLEX-V appliers have different features to accommodate surgeon preferences and approaches, but the V-shape implantable Clip (AOD2/V-Clip) is the same on each applier.
Figure 2
Figure 2
V-Clip post-market study attrition. CTA: computed tomography angiography; LAAE: left atrial appendage exclusion; TEE: transesophageal echocardiography.
See this image and copyright information in PMC

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