Left Atrial Appendage Management

AtriCure’s AtriClip products are the most widely sold Left Atrial Appendage (LAA) Management devices worldwide.

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The AtriClip devices are epicardially applied to the base of the left atrial appendage (LAA) during cardiac surgery procedures such that the LAA is permanently excluded from the left atrium of the heart. This exclusion eliminates communication of blood between the left atrium (LA) and the LAA and results in the electrical isolation of the LAA from the rest of the heart.1-4 The AtriClip devices are available on a variety of delivery systems optimized for open concomitant procedures as well as minimally invasive surgery, both through a thoracotomy and a port.

In peer reviewed science, AtriClip devices achieved an average exclusion success rate of more than 97% with success criteria of no residual flow between the LAA and LA and a residual LAA neck of ≤ 1.0 cm5-16. In these studies, there were no device migrations and no device related complications with more than 5 years of follow-up.

The AtriClip devices’ extraordinary performance may be due to its unique attributes:

  • Epicardial application causes ischemic injury and atrophy of the LAA and avoids placing foreign material directly into the blood stream.
  • Dynamic closing force maintains LAA exclusion throughout changes to the tissue caused by ischemia.
  • Non-piercing, atraumatic compression reduces risk of tissue tearing and bleeding.
  • Parallel, linear closure minimizes the occurrence of tissue folds and optimizes apposition of tissue along the long axis of the LAA ostia.
Learn More About the AtriClip LAA Exclusion System

 

  1. Benussi, S. et al, Thoracoscopic Appendage Exclusion With an AtriClip Device As a Solo Treatment for Focal Atrial Tachycardia. Circulation, 2011, 123:1575-8.
  2. Starck, CT et al, Epicardial left atrial appendage clip occlusion also provides the electrical isolation of the left atrial appendage. Interactive Cardiovascular and Thoracic Surgery, 2012, 15(3):416-419.
  3. Kamohara K et al. A novel device for left atrial appendage exclusion. J Thorac Cardiovasc Surg 2005, 130(6):1639-44.
  4. Kamohara K et al, Evaluation of a novel device for left atrial appendage exclusion: The second-generation atrial exclusion device, J Thorac Cardiovasc Surg, 2006, 132:340-6.
  5. Ailawadi et al, Exclusion of the Left Atrial Appendage with a Novel Device: Early Results of a Multicenter Trial. J Thorac Cardiovasc Surg, 2011, Nov; 142(5):1002-9, 9-8.
  6. Caliskan et al, Epicardial LAA AtriClip Occlusion Reduces the Incidence of Stroke in Patients with AF Undergoing Cardiac Surgery, Europace (2017)0, 1-10.
  7. Van Laar, Thoracoscopic Left Atrial Appendage Clipping: A Multicenter Cohort Analysis. JACC Clin Electrophysiol. 2018 4(7):893-901.
  8. Ellis et al, Angiographic Efficacy of the AtriClip Left Atrial Appendage Exclusion Device Placed by Minimally Invasive Thoracoscopic Approach, JACC Clin Electrophysiol 2017 Dec 11;3(12):1356-1365
  9. Kurfirst et al, Epicardial clip occlusion of the left atrial appendage during cardiac surgery provides optimal surgical results and long-term stability. Interact Cardiovasc Thorac Surg. 2017 25(1):37-40.
  10. Emmert et al, Safe Effective and Durable Epicardial Left Atrial Appendage Clip Occlusion in Patients with AF Undergoing Cardiac Surgery: First Long-term Results from a Prospective Device Trial.  European Journal of Cardio-Thoracic Surgery, 2014 Jan;45(1): 126-31.
  11. Ad et al, New Approach to Exclude the Left Atrial Appendage During Minimally Invasive Cryothermic Surgical Ablation. Innovations 2015; 10:323-327.
  12. Gerdisch et al, AtriClip PRO-V Left Atrial Appendage Occlusion Study, AtriCure Inc., Post Market Field Evaluation of the PRO-V Device, PM-US-0071A-1020-G.
  13. Mokracek et al, Thoracoscopic Occlusion of the Left Atrial Appendage, Innovations, vol 10, number 3, May/June 2015, 179-182.
  14. Page et al, Left Atrial Appendage Exclusion Using the AtriClip device: A Case Series, Heart Lung and Circulation, 2019 Mar;28(3):430-435.
  15. Beaver et al, Thoracoscopic Ablation with Appendage Ligation Versus Medical Therapy for Stroke Prevention: A Proof-of-Concept Randomized Trial Innovations 2016 Mar-Apr;11(2):99-105
  16. Toale et al, Outcomes of left atrial appendage occlusion using the AtriClip device: a systemic review, Interact CardioVasc Thorac Surgery (2019) 1-8 doi:10.1093/icvts/ivz156.
     

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