title: Concomitant Left Atrial Appendage Clipping During Minimally Invasive Mitral Valve Surgery: Technically Feasible and Safe.
abstract: BACKGROUND
  It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach.
  
  
  METHODS
  All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®). The patient s' clinical characteristics, intraoperative complications, and in-hospital coarse were obtained by reviewing the medical records.
  
  
  RESULTS
  Total of 22 patients(50% males) were included in the study. The median ages was 66.0 years (IQR: 50.8 to 81.3). Eight(36%) had mitral valve replacement and the rest had mitral repair surgery. Five(23%) patients needed blood product transfusion during the surgery. No clip related bleeding was observed and no perioperative mortality was recorded.
  
  
  CONCLUSIONS
  During minimally invasive mitral valve surgery, Concomitant exclusion of the left atrial appendage using AtriClip® can be performed rapidly and safely.
authors.affiliation: Department of Cardiology, St Josephs Medical Center, Paterson, NJ,USA.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Alqaqa
authors.affiliation: Department of Cardiothoracic surgery, St Josephs Medical Center, Paterson, NJ,USA.
authors.forename: Shabiah
authors.initials: S
authors.lastname: Martin
authors.affiliation: Department of Cardiology, St Josephs Medical Center, Paterson, NJ,USA.
authors.forename: Aiman
authors.initials: A
authors.lastname: Hamdan
authors.affiliation: Department of Cardiology, St Josephs Medical Center, Paterson, NJ,USA.
authors.forename: Fayez
authors.initials: F
authors.lastname: Shamoon
authors.affiliation: Department of Cardiothoracic surgery, St Josephs Medical Center, Paterson, NJ,USA.
authors.forename: Kourosh T
authors.initials: KT
authors.lastname: Asgarian
keywords: Left Atrial Appendage; Mitral Valve Surgery; Transesophageal Echocardiogram