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Updated: Feb 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

外科的左心耳閉鎖術後の左心耳残遺の管理

Anish K Desai¹, Jeffrey Chidester¹, Olivia Ondigi¹

¹Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia, USA.

JACC. Case reports

|February 5, 2026

要旨

Background:

Anticoagulation reduces the risk of stroke in patients with atrial fibrillation, but not all patients can tolerate therapy. Although surgical left atrial appendage occlusion (LAAO) offers an alternative approach, incomplete left atrial appendage (LAA) closure can present management challenges.

Case Series Summary:

We present 2 cases of residual LAA after surgical LAAO. In one case, an 81-year-old man with prior AtriClip developed anemia and subclinical bleeding, precluding long-term oral anticoagulation. Incomplete surgical LAA closure was confirmed on computed tomography, and he was successfully treated with transcatheter LAAO. In the second case, an 84-year-old woman with prior AtriClip and history of intracerebral hemorrhage presented after an acute ischemic stroke. Her high bleeding risk and residual LAA anatomy precluded both standard-dose therapeutic anticoagulation and transcatheter intervention.

Discussion:

Incomplete surgical LAA closure presents unique management challenges. Both transcatheter and medical management have roles, depending on individual patient anatomy and comorbidities. Careful follow-up imaging is crucial for identifying residual LAA patency after surgical occlusion.

キーワード:

抗凝固療法心房細動心血管疾患コンピューター断層撮影電気生理学出血画像診断血管内超音波閉鎖栓子血栓

さらに関連する動画

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

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