Left atrial appendage clip occlusion: early clinical results
Open accessAbstract
Objective Atrial fibrillation puts patients at significant risk for embolic stroke originating from the left atrial appendage. Few means are available for safe, effective, and durable left atrial appendage occlusion. A new clip device was evaluated with regard to safety and effectiveness for epicardial left atrial appendage occlusion.Methods Patients with atrial fibrillation undergoing elective cardiac surgery through a median sternotomy were enrolled for concomitant epicardial clip placement. Early postoperative and 3-month follow-up computed tomography studies were used to assess clip stability and left atrial appendage perfusion.Results From September 2007 to December 2008, 34 patients underwent successful clip placement. No device-related complications occurred. Operative mortality was 8.8% and not study or device related. Deployment was rapid, and left atrial appendage occlusion was confirmed by intraoperative transesophageal echocardiography in all patients. In addition to excellent clinical outcomes (no stroke/transient ischemic attack), serial computed tomography demonstrated stable clip location and appendage perfusion at 3 months in all patients.Conclusion Safe, effective, and durable left atrial appendage occlusion can easily be achieved with this new clip. Further trials are necessary to evaluate the role of the left atrial appendage occlusion in stroke prevention.
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Early positive observational data exist for thoracoscopic exclusion.
“More data are also needed to confirm the safety and efficacy of thoracoscopic exclusion, following early positive observational data.1037”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [1037]
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- Authors
- Salzberg, S. P., Plass, A., Emmert, M. Y., Desbiolles, L., Alkadhi, H., Grünenfelder, J., & Genoni, M.
- Affiliations
- University Hospital Zurich (CH)
- Corresponding author
- Salzberg, Sacha P.
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 139
- Issue
- 5
- Pages
- 1269-1274
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2013429510
- Cited by
- 134
- References
- 23
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 9 · 2021: 8 · 2020: 8 · 2019: 8 · 2018: 11 · 2017: 16 · 2016: 9 · 2015: 13 · 2014: 5 · 2013: 9 · 2012: 15
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- AtriCure
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- left atrial appendage closure, atrial fibrillation, stroke prevention, combined cardiac surgery, device safety
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Embolism, Equipment Design, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Pilot Projects, Risk Factors, Surgical Instruments, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Echocardiography, Transesophageal, Risk Assessment, Atrial Appendage, Stroke, Sternotomy
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