ArticleJTCVS techniques2021
Robotics-assisted epicardial left atrial appendage clip exclusion.
Article in JTCVS techniques, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Outcomes of Thoracoscopic Left Atrial Appendage Occlusion With or Without Concomitant Thoracoscopic Ablation - Multicenter Retrospective Registry of 567 Patients in Japan.Circulation reports · 2026Article
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Speech bubble sign - insights regarding incomplete left atrial appendage closure via electrocardiography-synchronized computed tomography in robotic surgery cases.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Robotic-assisted left atrial appendage occlusion: an important complementary option in the surgical management of atrial fibrillation.Interdisciplinary cardiovascular and thoracic surgery · 2025Observational
- Robotic-Assisted Minimally Invasive Direct Coronary Artery Bypass Grafting with Concomitant Left Atrial Appendage Exclusion.Brazilian journal of cardiovascular surgery · 2025Article
- Robotic-enhanced hybrid ablation for persistent and long-standing atrial fibrillation: Early assessment of feasibility, safety, and efficacy.JTCVS techniques · 2024Article
- Commentary: Targeting the left atrial appendage.JTCVS techniques · 2021Article
- Commentary: A complex tool for a simple task. Robotic AtriClip application.JTCVS techniques · 2021Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe demonstrate the feasibility and safety of robotics-assisted left atrial appendage clip exclusion in clinical practice.
methodsAnalysis of a single center robotics-assisted left atrial appendage clip exclusion experience using an epicardial linear clip device in patients with atrial fibrillation with high-risk of thromboembolic stroke and intolerance to oral anticoagulants.
resultsDuring the period from December 2017 to September 2020, we performed 42 robotics-assisted left atrial appendage clip exclusions in response to increased risk of bleeding in patients with atrial fibrillation and intolerance to oral anticoagulants. The average congestive heart failure, hypertension, age, diabetes, stroke, and vascular disease score was 5.2 ± 1.6 and hypertension, abnormal liver or kidney function, stroke, bleeding, labile international normalized ratio, elderly, drugs (aspirin, other antiplatelets, or anticoagulants) score was 4.5 ± 0.9. No patients died intraoperatively or within 30 days, or due to conversion to thoracotomy, intraoperative complications, or failure to apply the clip satisfactorily. The procedure was successfully completed despite pericardial adhesions in 2 patients with prior coronary bypass grafts and 3 with postpericarditis scars. Intraoperative transesophageal echocardiography was performed in 38 out of 42 patients; satisfactory exclusion with left atrial appendage stump <5 mm was confirmed in all. Average length of stay was 3.4 ± 3 days with 12 out of 42 patients discharged within 24 hours. Oral anticoagulants were discontinued in 41 out of 42 patients and no cases of 30-day stroke, myocardial ischemia, or new arrhythmias were observed. One case of hemothorax required thoracoscopy a day later. There was no reported thromboembolic stroke or transient ischemic attack at 12 months. One case of late lacunar stroke was due to in situ small intracranial vessel thrombosis without left atrial appendage thrombus on imaging.
conclusionsRobotics-assisted left atrial appendage clip exclusion is a safe and feasible minimally invasive method for left atrial appendage management in patients with atrial fibrillation with intolerance to oral anticoagulants and increased risk of thromboembolic stroke.
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