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Updated: Aug 13, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Robotic-assisted left atrial ligation for stroke reduction in chronic atrial fibrillation: a case report
Bob Kiaii1, R Scott McClure, Alan C Skanes
1London Health Sciences Centre, London, Ontario, Canada. bob.kiaii@lhsc.on.ca
Insights
This study presents the first case of robotic-assisted left atrial appendage ligation as a standalone procedure for patients with atrial fibrillation who cannot use anticoagulation, offering a new stroke prevention option.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Robotics
Background:
- Atrial fibrillation significantly increases stroke risk due to thromboemboli originating from the left atrial appendage.
- Left atrial appendage ligation is an established stroke reduction technique, typically performed adjunctively during other cardiac surgeries.
- Standalone left atrial appendage ligation has been limited by invasiveness concerns.
Observation:
- A case report details a patient with chronic atrial fibrillation and contraindications for anticoagulation.
- The patient underwent a port-access robotic-assisted left atrial appendage ligation as a standalone procedure.
- This represents a novel minimally invasive approach for stroke risk reduction in this patient cohort.
Findings:
- Successful execution of robotic-assisted left atrial appendage ligation as a primary, stand-alone intervention.
- Demonstrates feasibility of the port-access technique for isolated left atrial appendage ligation.
- Highlights a potential alternative for stroke prevention in anticoagulation-intolerant atrial fibrillation patients.
Implications:
- Suggests robotic-assisted surgery may overcome invasiveness barriers for stand-alone left atrial appendage ligation.
- Paves the way for further investigation into minimally invasive stroke prevention strategies in atrial fibrillation.
- Offers a potential therapeutic avenue for patients with contraindications to anticoagulation therapy.
Abstract:
Patients with atrial fibrillation are at significant risk for sustaining a thromboembolic stroke. More than 90% of thromboemboli form in the left atrial appendage. Ligation of the left atrial appendage to reduce the risk of stroke is often performed in connection with other cardiac surgical procedures. As a stand-alone procedure, however, left atrial ligation has generally been deemed too invasive and has gained little support as an alternative therapeutic option. We report a case of port-access robotic-assisted left atrial ligation as a stand-alone procedure in a patient with chronic atrial fibrillation in whom anticoagulation was a contraindication. To our knowledge, this is the first reported case of stand-alone robotic-assisted left atrial ligation in the literature.
