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Updated: Dec 20, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Minimally invasive, simplified double-layer left atrial appendage closure
Ahmed Alnajar1,2, Corinne Aberle1,2, Joseph Lamelas1,2
1Division of Cardiothoracic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Insights
Left atrial appendage (LAA) closure during mitral valve surgery effectively prevents stroke. This minimally invasive technique offers a safe and reproducible solution for patients with atrial fibrillation, reducing embolism risk.
Area of Science:
- Cardiology
- Cardiac Surgery
- Neurology
Background:
- The left atrial appendage (LAA) is a primary source of embolic events, particularly stroke, in patients with atrial fibrillation.
- Effective LAA closure is crucial, as incomplete closure significantly elevates stroke risk.
- Current guidelines recommend LAA closure during cardiac surgery, especially mitral valve surgery.
Purpose of the Study:
- To introduce a novel, simple, and reproducible method for complete LAA closure during mitral valve surgery.
- To evaluate the safety and efficacy of this technique in preventing thromboembolic events.
Main Methods:
- Development of a unique surgical technique for complete LAA closure.
- Application of the technique during mitral valve surgery in three patients.
- Long-term follow-up to assess for stroke and neurological events.
Main Results:
- The developed LAA closure method was successfully implemented in all three patients.
- Patients remained completely free from stroke and transient neurological manifestations for 27 months post-surgery.
- The technique proved to be safe and efficacious in preventing LAA-related embolism.
Conclusions:
- This new method ensures complete LAA closure during mitral valve surgery, a critical step in stroke prevention for atrial fibrillation patients.
- The technique is safe, reproducible, and effective in reducing the risk of stroke and embolism.
- Minimally invasive LAA closure represents a significant advancement in cardiac surgery for managing atrial fibrillation-related stroke risk.
Abstract:
The left atrial appendage (LAA) has been identified as a site of thrombus formation in the heart and as a source of embolism in patients with atrial fibrillation, leading to stroke. Studies suggest that LAA closure may reduce the risk for stroke and the need for anticoagulation; conversely, incomplete closure can increase the stroke risk almost 12-fold. Because open heart surgery is associated with increased risk for subsequent stroke, surgeons generally prefer to close the LAA during heart surgery, as recommended in current atrial fibrillation management guidelines. Building on trends toward minimally invasive approaches in cardiac surgery, we developed a simple, unique, and reproducible method for complete LAA closure during mitral valve surgery that has proven to be safe and efficacious: Our first three patients remained completely free from stroke and minor neurological manifestations 27 months after surgery.
