Thoracoscopic left atrial appendage clipping as novel treatment option for peri-device leakage

A 69-year-old woman known with symptomatic antiarrhythmic drug refractory paroxysmal atrial fibrillation (AF), stroke (CHA2DS2-VASc score 5), and therapy-resistant epilepsy resulting in collapses with risk for head trauma (HAS-BLED score 3), underwent catheter ablation and transcatheter left atrial appendage (LAA) occlusion (WATCHMANTM 24  mm, Boston Scientific, Natick, MA, USA). Computed tomography (CT) scan revealed significant peri-device leakage (4–5 mm). Due to the absolute contra-indication for oral anticoagulation therapy, the patient was referred for thoracoscopic LAA-clipping (Atriclip PRO 145, AtriCure Inc., Dayton, O H, USA). Additionally, a totally thoracoscopic MAZE procedure (TT-MAZE) was performed. Perioperative Transesophageal echocardiography (TEE) showed complete closure of the LAA, which was confirmed on CT-scan performed 2 months after surgery.
Source: Europace - Category: Cardiology Source Type: research