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Related Experiment Video

Updated: Apr 24, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Thoracoscopic left atrial appendectomy.

Miguel Guerra1, Daniel Martins, José Miranda

  • 1Serviço de Cirurgia Cardiotorácica do Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular
|September 10, 2014
PubMed
Summary
This summary is machine-generated.

For patients with atrial fibrillation unsuitable for anticoagulation, left atrial appendage (LAA) closure prevents stroke. Thoracoscopic LAA excision offers a safe alternative when percutaneous closure is not feasible.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Devices

Background:

  • Oral anticoagulation effectively prevents stroke in non-rheumatic atrial fibrillation.
  • Certain patients, due to bleeding risk or prior hemorrhage, cannot tolerate long-term anticoagulation.
  • Percutaneous left atrial appendage (LAA) closure is an alternative for stroke prevention in these patients.

Observation:

  • A challenging case involved an 82-year-old male with a history of intracerebral hemorrhage.
  • The patient's two-lobed LAA anatomy precluded effective percutaneous occlusion.
  • This necessitated an alternative strategy to manage thromboembolic risk.

Findings:

  • A videothoracoscopic LAA excision was successfully performed.
  • This procedure completely removed the LAA, addressing the anatomical limitations for percutaneous closure.
  • The approach eliminated the need for oral anticoagulant therapy.

Implications:

  • Thoracoscopic LAA excision is a potentially safe and effective alternative to percutaneous closure.
  • It provides a viable option for patients at high risk of thromboembolism and intolerance to anticoagulation.
  • This surgical technique may be considered for complex LAA anatomies unsuitable for device-based closure.