[Clinical Analysis of Thoracoscopic Left Atrial Appendage Amputation]

The left atrial appendage (LAA), a major source of thrombus formation, is also a common site for ectopic foci that initiate and maintain atrial fibrillation( AF). Depending on the patient's condition, various methods are available to exclude LAA, and each of these means is associated with advantages and disadvantages. We performed thoracoscopic stand-alone LAA amputation in 47 patients with AF, who were at risk of stroke with or without contraindications to anticoagulation therapy (between March 2017 and November 2022). A thoracoscopic procedure was completed in 46 patients, and only one patient required open surgery. Anticoagulation therapy was discontinued in 36 patients( 76.6%);however, one patient developed stroke, which necessitated resumption of anticoagulation therapy. Catheter ablation before or after thoracic LAA amputation was performed in 16 patients, and 13( 81.3%) patients continued to show regular sinus rhythm during follow-up (median 11.5 months). Thoracoscopic standalone LAA amputation is minimally invasive and safe. Furthermore, combination of this procedure with conventional catheter ablation may serve as the most reliable curative therapeutic approach to AF.