Related Experiment Video
Updated: Apr 19, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Video-assisted thoracoscopic surgery atrial clipping for atrial fibrillation
Harish Mithiran1, Jai Sule2, Faizus Sazzad2
1Department of Cardiac, Thoracic & Vascular Surgery, National University Health System, Singapore dr.harish@live.com.
Insights
Left atrial appendage occlusion using video-assisted thoracoscopic surgery effectively prevents stroke in atrial fibrillation patients when anticoagulation is contraindicated. This minimally invasive approach targets the primary source of thrombi.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Devices
Background:
- Atrial fibrillation frequently leads to thrombus formation in the left atrial appendage.
- Thrombi originating from the left atrial appendage are a major cause of embolic stroke.
- Anticoagulation therapy is standard but contraindicated in some patients due to bleeding risks.
Observation:
- A unique case involved a patient with atrial fibrillation and a history of gastrointestinal bleeding.
- The patient was unsuitable for standard anticoagulation therapy.
- Video-assisted thoracoscopic surgery (VATS) was employed for left atrial appendage occlusion.
Findings:
- The procedure successfully occluded the left atrial appendage using an Atriclip device.
- Minimally invasive VATS provided an effective alternative to anticoagulation.
- The patient's stroke risk was mitigated through targeted appendage exclusion.
Implications:
- Left atrial appendage occlusion via VATS is a viable therapeutic option for select atrial fibrillation patients.
- This technique offers a stroke prevention strategy for individuals with contraindications to anticoagulation.
- Further research may explore the long-term efficacy and broader application of this surgical approach.
Abstract:
The majority of thrombi that arise due to atrial fibrillation occur in the left atrial appendage. Eliminating this cul-de-sac within the left atrium reduces the risk of stroke in these patients. We present a unique case of left atrial appendage occlusion performed via video-assisted thoracoscopic surgery, using an Atriclip to occlude the left atrial appendage in a patient with atrial fibrillation in whom anticoagulation was contraindicated due to a history of recurrent upper gastrointestinal bleeding.
