Novel Solution for Left Main Coronary Artery Obstruction During Surgical Left Atrial Appendage Clipping
Hiroshi Nakanaga1, Akifumi Bando2, Yoshinari Nagaoka1
1Department of Cardiovascular Surgery, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan.
Background:
Left main coronary artery occlusion during surgical left atrial appendage closure is a rare but critical complication.
Case Summary:
We report 2 cases of left main coronary artery occlusion diagnosed intraoperatively during concomitant surgical left atrial appendage closure with a clipping device via an endoscopic minimally invasive approach. Both cases were successfully managed by suturing the clip to the left atrial wall, distancing it from the coronary artery.
Discussion:
Previous reports have documented this complication, but this is the first report of using this particular resolution method. Our approach provides a physiological solution to left main coronary artery obstruction, offering a practical and effective strategy for intraoperative management.
Take-Home Message:
Awareness and prompt management of this complication are crucial during LAAO procedures. The novel method of suturing the clip to the cranial left atrial wall effectively resolves the issue.
