Concomitant Convergent Ablation, Left Atrial Appendage Closure, and Minimally Invasive Direct Coronary Artery Bypass: A Case Series.

We present the first report of concomitant convergent ablation, left atrial appendage (LAA) closure, and minimally invasive direct coronary artery bypass (MIDCAB) procedures during a single operation. Three patients had coronary artery disease of the left anterior descending artery and atrial fibrillation. All were offered concomitant convergent ablation and LAA closure during the MIDCAB procedure. There were no intra- or postoperative events. At one-year follow-up, no serious adverse events had occurred. One patient had experienced a relapse of paroxysmal atrial fibrillation, and one patient, with a well-functioning graft, had been medically optimized for angina. Our report shows that combining convergent ablation, LAA closure, and MIDCAB can be done feasibly and safely, enabling efficient minimally invasive approaches to future complex cases.