Left atrial appendage clip occlusion: early clinical results.
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.


CONCLUSIONS
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.
Salzberg
Sacha P
SP
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland. sacha.salzberg@gmail.com
Plass
Andre
A
Emmert
Maximillian Y
MY
Desbiolles
Lotus
L
Alkadhi
Hatem
H
Grünenfelder
Jurg
J
Genoni
Michele
M
D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D018570:Risk Assessment; D012307:Risk Factors; D056346:Sternotomy; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013525:Surgical Instruments; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome