Robotic-Assisted Left Atrial Ligation for Stroke Reduction in Chronic Atrial Fibrillation: A Case Report

Authors

  • Bob Kiaii
  • R. Scott McClure
  • Alan C. Skanes
  • Ian G. Ross
  • Alison R. Spouge
  • Stuart Swinamer
  • Reiza Rayman
  • Daniel T. Bainbridge
  • Ivan Iglesias
  • Richard J. Novick

DOI:

https://doi.org/10.1532/HSF98.20051148

Abstract

Patients with atrial fibrillation are at significant risk for sustaining a thromboembolic stroke. More than 90% of thromboemboli form in the left atrial appendage. Ligation of the left atrial appendage to reduce the risk of stroke is often performed in connection with other cardiac surgical procedures. As a stand-alone procedure, however, left atrial ligation has generally been deemed too invasive and has gained little support as an alternative therapeutic option. We report a case of port-access robotic-assisted left atrial ligation as a stand-alone procedure in a patient with chronic atrial fibrillation in whom anticoagulation was a contraindication. To our knowledge, this is the first reported case of stand-alone robotic-assisted left atrial ligation in the literature.

References

Guiraudon GM. 1993. Surgical treatment of atrial fibrillation. Herz 18:51-9.nJohnson WD, Ganjoo AK, Stone CD, et al. 2000. The left atrial appendage: our most lethal human attachment! Surgical implications. Eur J Cardiothorac Surg 17:718-22.nKannel WB, Wolf PA, Benjamin EJ, et al. 1998. Prevalence, incidence, prognosis and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 82:2N-9N.nLeckey R, Aguilar EG, Phillips SJ. 2000. Atrial fibrillation and the use of warfarin in patients admitted to an acute stroke unit. Can J Cardiol 16:481-5.nSievert H, Lesh MD, Trepels T, et al. 2002. Percutaneous left atrial appendage transcatheter occlusion to prevent stroke in high-risk patients with atrial fibrillation. Early clinical experience. Circulation 105:1887-9.nBenjamin EJ, Levy D, Vaziri SM, et al. 1994. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 271:840-4.nBlackshear JL, Johnson WD, Odell JA, et al. 2003. Thoracoscopic extracardiac obliteration of the left atrial appendage for stroke risk reduction in atrial fibrillation. J Am Coll Cardiol 42:1249-52.nBlackshear JL, Odell JA. 1996. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 61:755-9.nFeinberg WM, Blackshear JL, Laupacis A, et al. 1995. Prevalence, age distribution and gender in patients with atrial fibrillation; analysis and implications. Arch Intern Med 155:469-73.nSudlow M, Thomson R, Thwaites B, et al. 1998. Prevalence of atrial fibrillation and eligibility for anticoagulants in the community. Lancet 352:1167-71.nYamanouchi H, Tomonago M, Shimada H, et al. 1989. Non-valvular atrial fibrillation as a cause of fatal massive cerebral infarction in the elderly. Stroke 20:1653-6.n

Published

2005-12-29

How to Cite

Kiaii, B., McClure, R. S., Skanes, A. C., Ross, I. G., Spouge, A. R., Swinamer, S., Rayman, R., Bainbridge, D. T., Iglesias, I., & Novick, R. J. (2005). Robotic-Assisted Left Atrial Ligation for Stroke Reduction in Chronic Atrial Fibrillation: A Case Report. The Heart Surgery Forum, 9(1), E533-E535. https://doi.org/10.1532/HSF98.20051148

Issue

Section

Article