Key result
AtriClip LAA occlusion during cardiac surgery achieves 96% successful closure without device-related thrombus.
Why the study?
LAA occlusion during cardiac surgery reduces postoperative embolic stroke in atrial fibrillation, but the optimal method for occlusion is not universally accepted.
Does left atrial appendage occlusion with the AtriClip epicardial occlusion device provide successful closure and safety in cardiac surgical patients with atrial fibrillation?
Observational (n=97)
No
Does left atrial appendage occlusion with the AtriClip epicardial occlusion device provide successful closure and safety in cardiac surgical patients with atrial fibrillation?
The AtriClip epicardial occlusion device provides a high rate (96%) of successful left atrial appendage closure without device-related thrombus or thromboembolic events at nearly 2 years of follow-up.
Supports AtriClip for LAA closure in surgical AF patients; leaves open randomized confirmation of thromboembolic benefit.
Objective: Left atrial appendage (LAA) occlusion at the time of cardiac surgery in patients with atrial fibrillation has been shown to reduce the incidence of postoperative embolic stroke. However, the optimal method for LAA occlusion is not universally accepted. We sought to examine the safety and effectiveness of LAA occlusion with the AtriClip epicardial occlusion device. Methods: Cardiac surgical patients with atrial fibrillation who underwent LAA AtriClip placement were evaluated prospectively. Clip placement and clinical outcomes were examined after 1 year of follow-up with transesophageal echocardiography (TEE). The presence of a 10 mm or greater residual pouch, presence of flow into the LAA, or device-related thrombus (DRT) were considered failures. Results: Ninety-seven patients were analyzed. The mean CHA 2 DS 2 -VASc score was 2.4 ± 1.4. The postoperative follow-up period ranged from 366 to 1,693 days (mean 685 days or 1.87 years). Seventy-four AtriClips were placed with video-assisted thoracic surgery, whereas 23 were placed via sternotomy or thoracotomy. Successful closure was found in 96% (93 of 97) of patients at follow-up. Failure occurred in 4 patients. No clip migration or DRT was seen on 3-dimensional imaging. Of all 97 patients, 76 (78%) were on presurgical oral anticoagulation, whereas 5 (5.1%) were on postprocedure oral anticoagulation. There were no postoperative thromboembolic events at the time of the study TEE. Conclusions: The AtriClip epicardial surgical occlusion device can provide an excellent rate of successful closure of the LAA during surgical ablation procedures without DRT.
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Kiankhooy et al. (2022) conducted an observational in Atrial fibrillation (n=97). AtriClip epicardial occlusion device was evaluated on Successful closure (absence of 10 mm or greater residual pouch, flow into the LAA, or device-related thrombus). Left atrial appendage occlusion using the AtriClip device during cardiac surgery achieved successful closure in 96% of patients at a mean follow-up of 1.87 years, with no device-related thrombus.
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