Isolated surgical left atrial appendage closure: Revisiting utility and indications in a burgeoning era of percutaneous therapy.

BACKGROUND AND AIM: Oral anticoagulation (AC) and percutaneous left atrial appendage (LAA) occlusion are the primary treatment modalities for stroke prevention in atrial fibrillation (AF), but there remains a subset of patients in whom these approaches present excess risk and isolated surgical LAA excision should be considered. We describe a 63-year-old female with AF and recurrent thromboembolic events who presented with an acute intraparenchymal hemorrhage and was found to have an intracardiac thrombus.

METHODS

Given contraindications to AC and LAA occlusion, an isolated LAA surgical excision was pursued.

RESULTS

She underwent successful surgical LAA excision and has since remained event-free.

CONCLUSION

It is important to recall the utility of therapies that have been previously used with success for intracardiac thrombi and still remain as viable options.