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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

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Angiographic Efficacy of the Atriclip Left Atrial Appendage Exclusion Device Placed by Minimally Invasive

Christopher R Ellis1, Sam G Aznaurov1, Neel J Patel1

  • 1Vanderbilt University Medical Center, Nashville, Tennessee.

JACC. Clinical Electrophysiology
|May 16, 2018
PubMed

Insights

The Atriclip device, applied via a totally thoracoscopic approach, demonstrates high efficacy for left atrial appendage closure. This minimally invasive method shows promising results for preventing atrial fibrillation-related embolic stroke.

Area of Science:

  • Cardiology
  • Minimally Invasive Surgery
  • Medical Devices

Background:

  • Left atrial appendage (LAA) closure reduces embolic stroke risk in atrial fibrillation.
  • The Atriclip device enables epicardial LAA closure, potentially avoiding oral anticoagulation.
  • Prior studies of open-chest Atriclip procedures show >95% closure efficacy.

Purpose of the Study:

  • To evaluate the long-term efficacy of Atriclip for LAA closure using a totally thoracoscopic (TT) approach.
  • To assess the rate of complete LAA exclusion via computed tomographic angiography (CTA) at least 90 days post-implantation.

Main Methods:

  • Retrospective analysis of patients who received TT-placed Atriclip at Vanderbilt University Medical Center (2011-2015).
  • Three-dimensional, 2-phase CTA performed ≥90 days post-implantation.
  • Independent radiological assessment for complete LAA closure defined by specific criteria.

Main Results:

  • Complete LAA closure was achieved in 93.9% (61/65) of subjects.
  • Incomplete closure occurred in 6.2% (4/65) due to device placement or secondary lobe issues.
  • No major complications were noted with TT Atriclip placement; one stroke occurred in a patient with complete closure.

Conclusions:

  • TT-placed Atriclip achieves high angiographic LAA closure efficacy (93.9%).
  • The clinical impact of residual LAA stumps requires further investigation.
  • Confirming complete LAA occlusion is crucial before discontinuing anticoagulation.
Abstract

Keywords:
anticoagulationatrial fibrillationleft atrial appendagestrokethoracoscopy

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