Related Experiment Video
Updated: Jul 17, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Thoracoscopic Left Atrial Appendage Occlusion with the AtriClip PRO2: An Experience of 144 Patients
Edward Wang1, Paul Sadleir2, Vijay Sourinathan3
1Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia.
Insights
Thoracoscopic left atrial appendage occlusion (LAAO) using the AtriClip PRO2 device achieved 100% complete closure with no major complications. This safe and effective method shows promise for stroke risk reduction in atrial fibrillation patients.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Minimally Invasive Procedures
Background:
- Left atrial appendage occlusion (LAAO) is established for stroke risk reduction in atrial fibrillation.
- Percutaneous LAAO devices face challenges with complications and peridevice flow.
- Thoracoscopic AtriClip offers epicardial closure at the ostium.
Purpose of the Study:
- To evaluate the clinical outcomes of thoracoscopic LAAO with the AtriClip PRO2 device.
- To assess the safety and efficacy of achieving complete LAA closure.
- To determine the rate of thromboembolic phenomena after anticoagulation cessation post-standalone AtriClip.
Main Methods:
- Prospective series of 144 thoracoscopic AtriClip PRO2 procedures (56 standalone, 88 concomitant).
- Procedures performed by a single surgeon between 2017 and 2022.
- Ethical approval obtained from the hospital Human Research Ethics Committee.
Main Results:
- 100% success rate in complete LAA closure observed.
- No mortality or major morbidities reported.
- No thromboembolic phenomena in 180 patient-years of follow-up for standalone AtriClip patients after anticoagulation cessation.
Conclusions:
- Thoracoscopic AtriClip placement is safe and effective for consistent, complete LAAO.
- The procedure demonstrates excellent clinical outcomes.
- Further randomized trials are warranted to compare with percutaneous devices.
Aim:
To report the clinical outcomes of thoracoscopic left atrial appendage occlusion (LAAO) with the AtriClip PRO2 device (Atricure Inc, Mason, OH, USA). Stroke risk reduction with LAAO in patients with atrial fibrillation is now well-established. Many surgical and percutaneous techniques have been used, with varying rates of success. The percutaneous devices have had issues with procedural complications and peridevice flow. Thoracoscopic AtriClip offers an epicardial linear closure of the appendage at its ostium. This study sought to evaluate its safety and efficacy in achieving complete LAA closure.
Method:
This is a prospective series of thoracoscopic AtriClip PRO2 as a standalone procedure or a thoracoscopic AtriClip deployed as an adjunct to minimal access cardiac and thoracic surgery. Study ethical approval was granted by the hospital Human Research Ethics Committee.
Results:
In total, 144 thoracoscopic AtriClip procedures were conducted by a single surgeon from 2017 to 2022, 56 standalone and 88 concomitant. There was no mortality or major morbidities. A 100% success in complete LAA closure was observed, with 87% complete follow-up imaging. For patients that underwent standalone AtriClip after cessation of anticoagulation, no thromboembolic phenomena were seen in the 180 patient-years of follow-up.
Conclusions:
This study demonstrates that thoracoscopic placement of AtriClip is safe and effective in achieving consistent and complete LAAO. Future randomised trials will be useful to compare outcomes with percutaneous devices.
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