A Case of Cardiogenic Stroke After Thoracoscopic Left Atrial Appendectomy

Area of Science:

• Cardiology
• Minimally Invasive Surgery

Background:

• Thoracoscopic left atrial appendectomy is an alternative to oral anticoagulants for stroke risk reduction in non-valvular atrial fibrillation.
• It is particularly considered for patients at high risk of stroke and bleeding on anticoagulation therapy.

Observation:

• A 74-year-old male patient experienced a cardiogenic stroke following thoracoscopic left atrial appendectomy.
• This complication occurred despite the procedure aiming to eliminate the need for long-term oral anticoagulation.

Findings:

• Contrast-enhanced cardiac computed tomography (CT) was utilized to assess the risk of postoperative cardiogenic stroke.
• Cardiac CT findings guided the formulation of a postoperative management strategy.

Implications:

• This case underscores the importance of individualized risk assessment for postoperative cardiogenic stroke after left atrial appendectomy.
• The findings suggest that short-term oral anticoagulation therapy, guided by cardiac CT, may be necessary for select patients.
• This approach optimizes stroke risk management in the post-procedural period.