Surgical Treatment for Left Atrial Appendage Closure

Patients with atrial fibrillation (AF) are at risk for ischemic stroke due to the increased likelihood of developing a thrombus in the left atrium. Oral anticoagulants are the current standard of care, but intake and adherence remain a challenge. In non-valvular AF, the left atrial appendage is the primary source of embolization with left atrial appendage (LAA) occlusion as an effective method of stroke prevention. Mechanical methods of occlusion can employ percutaneous endocardial devices or surgical exclusion during cardiac surgery. The AtriClip®, Penditure®, and Watchman® devices, in addition to surgical stapling, are highly efficacious LAA occlusion techniques. Left atrial appendage occlusion with the AtriClip® in patients at elevated risk for stroke, but with no previous diagnosis of AF, is currently under investigation. Additionally, the Penditure® LAA exclusion system is recently available for clinical practice and under post-marketing analysis.