The role of cardiac imaging before and after left atrial appendage standalone thoracoscopic exclusion.

Aims: To assess the characteristics of left atrial appendage (LAA) stump and left atrial (LA) volume after standalone totally thoracoscopic LAA exclusion in 40 patients with nonvalvular atrial fibrillation (NVAF) and contraindications to oral anticoagulation (OAC), using cardiac computed tomography (CCT) and transoesophageal echocardiography (TOE).

Methods: Using CCT and TOE, we evaluated correct AtriClip Pro II positioning, the presence and characteristics of the LAA stump and the postprocedural LA volume, at 3 months' follow-up. Stump depth was measured with both CCT and TOE using a new method, based on left circumflex artery (LCX) course.

Left atrial function after standalone totally thoracoscopic left atrial appendage exclusion in atrial fibrillation patients with absolute contraindication to oral anticoagulation therapy.

Background: Left atrial appendage (LAA) is a common source of thrombi in patients with atrial fibrillation (AF). The effect on left atrial (LA) function of the Totally Thoracoscopic (TT)-LAA exclusion with epicardial clip is currently unknown. This study aims at evaluating the effect of TT-LAA exclusion on LA function.

Quantitative assessment of transmural fibrosis profile in the human atrium: evidence for a three-dimensional arrhythmic substrate by slice-to-slice histology.

Aims: Intramural fibrosis represents a crucial factor in the formation of a three-dimensional (3D) substrate for atrial fibrillation (AF). However, the transmural distribution of fibrosis and its relationship with atrial overload remain largely unknown. The aim of this study is to quantify the transmural profile of atrial fibrosis in patients with different degrees of atrial dilatation and arrhythmic profiles by a high-resolution 3D histology method.

Heart Team for Left Atrial Appendage Occlusion: A Patient-Tailored Approach.

Background And Purpose: Left atrial appendage occlusion (LAAO) is an accepted therapeutic option for stroke prevention; however, the ideal technique and device have not yet been identified. In this study we evaluate the potential role of a heart team approach for patients contraindicated for oral anticoagulants and indicated for left atrial appendage closure, to minimize risk and optimize benefit in a patient-centered decision-making process.

Methods: Forty patients were evaluated by the heart team for appendage occlusion.

Standalone Totally Thoracoscopic Left Appendage Clipping: Safe, Simple, Standardized.

Totally thoracoscopic standalone left atrial appendage exclusion has become a valid treatment option for stroke prevention in patients with a contraindication to anticoagulants. As with most other video-assisted surgeries, this procedure requires appropriate patient and port positioning to obtain the most advantageous working angles and standard thoracoscopic skills. Furthermore it is mandatory to have a closure device specifically designed for the appendage to guarantee efficacy and safety and to optimize surgical placement that allows the best clinical outcomes.