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Updated: Apr 26, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Filling the gap: interventional occlusion of incompletely ligated left atrial appendages
Stefano Bordignon1, Alexander Fürnkranz1, Laura Perrotta1
1Med. Klinik III, Cardioangiologisches Centrum Bethanien, Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany.
Aims:
Patients undergoing heart surgery and with history of atrial fibrillation are often treated with intraoperative left atrial appendage (LAA) ligation. Incomplete LAA ligation is often described and can be associated with thrombo-embolic complications. To describe a case series of percutaneous LAA occlusion in patients previously treated with surgical LAA ligation.
Methods And Results:
Over 179 patients treated with implantation of an LAA-occluder system at our centre, 3 (1.6%) were previously treated with a surgical LAA suture exclusion (2 males, age 74 ± 3 years). Patients 1 and 3 presented a 'hammerhead' LAA morphology with an open neck and were successfully treated with an AGA Cardiac Plug (ACP-St Jude Medical) Device. Patient 2 had a conic monolobar LAA with a small neck, and the occlusion could be performed using a Watchman (Boston Scientific) device. After discharge on dual antiplatelet therapy, all the patients could be switched to single aspirin (ASA) therapy after a 6-week transoesophageal echocardiography control.
Conclusion:
Left atrial appendage occlusion in patient with incomplete surgical ligation using percutaneous LAA occluder devices appears to be feasible, and studies including a larger number of patients are needed.
