Transhepatic approach: A safe alternative for left atrial appendage closure in challenging anatomical cases—A report of 2 cases and narrative review

Given that the majority of thrombi associated with atrial fibrillation in the left atrium originate within the left atrial appendage (LAA), historically, the surgical excision or exclusion of the appendage has been attempted as a prophylactic measure, albeit with initially elevated morbidity and mortality rates. 1