Evidence map›Paper›PMID 40193468›Full record

Observational studyInterdisciplinary cardiovascular and thoracic surgery2025

Robotic-assisted left atrial appendage occlusion: an important complementary option in the surgical management of atrial fibrillation.

Alfonso Agnino, Laura Giroletti, Eduardo Celentano, Ascanio Graniero, Ernesto Cristiano, Matteo Parrinello, Giovanni Albano, Mario Gasparri, Stefano Schena

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alfonso AgninoDepartment of Cardiovascular Surgery, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Laura GirolettiDepartment of Cardiovascular Surgery, Humanitas Gavazzeni-Castelli, Bergamo, Italy.ORCID 0009-0004-4067-2781
Eduardo CelentanoDepartment of Cardiac Electrophysiology, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Ascanio GranieroDepartment of Cardiovascular Surgery, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Ernesto CristianoDepartment of Cardiac Electrophysiology, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Matteo ParrinelloDepartment of Cardiac Anesthesia, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Giovanni AlbanoDepartment of Cardiac Anesthesia, Humanitas Gavazzeni-Castelli, Bergamo, Italy.
Mario GasparriDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Stefano SchenaDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe growing popularity of minimally invasive treatment of atrial fibrillation (AF) has shown increasing interest in concomitant left atrial appendage occlusion (LAAO). Surgical robotic technology adds advantages such as magnified visualization, enhanced dexterity of movement and decreased invasiveness. The aim of this study is to evaluate the effectiveness and early outcomes of robotic-assisted LAAO.

methodsThis is an observational, multicentre, retrospective study of patients with AF who underwent robotic-assisted LAAO. In-hospital mortality, perioperative complications, length of stay (LOS) and imaging-driven (cardiac CT scan, transesophageal echocardiography [TEE]) efficacy at 3-month follow-up were analysed.

resultsBetween August 2019 and June 2024, 194 patients with documented AF (70.4% male, mean age 67.7 ± 10.1) underwent robotic-assisted epicardial LAAO. The procedure was performed under TEE guidance in 193 patients without complications. In one patient with previous sternotomy, LAAO was not feasible. Blood product transfusion was necessary in one patient, due to significant chest wall bleeding requiring thoracoscopic re-exploration. No stroke or thromboembolic events were observed. Left hemidiaphragm paralysis requiring plication occurred in 3 patients (1.5%). Hospital mortality was 0%. Mean LOS time was 2.2 days (range 1-10 days) and all patients were discharged home. Imaging follow-up was complete in 157 cases (81%) and was achieved by TEE in 91 patients while the remaining 66 underwent cardiac CT scan. Two patients had residual flow in the left atrial appendage and oral anticoagulant was continued at follow-up.

conclusionsRobotic-assisted LAAO is safe with satisfactory outcome both in an isolated setting and with concomitant hybrid ablating procedures for patients with AF.

Indexed as

Atrial AppendageAtrial FibrillationCardiac Surgical ProceduresRobotic Surgical ProceduresAgedEchocardiography, TransesophagealFemaleHospital MortalityHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTime FactorsTreatment Outcomeatrial fibrillationleft appendage closurerobotic cardiac surgery

Identifiers

PMID40193468
PMCPMC12014094

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.