{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:57Z","timestamp":1753876197618,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Closure of the left atrial appendage (LAA) using a clip in at-risk patients reduces stroke risk. The rate of LAA closure procedures is increasing worldwide; however, complications have been reported, with coronary compression being one possible lethal complication associated with the anatomical structures around the LAA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 75-year-old man presented with a diagnosis of a \u03c650\u2005mm saccular thoracic aortic aneurysm. He had a history of chronic atrial fibrillation and functional tricuspid regurgitation. We performed total arch replacement with an open stent graft, tricuspid ring annuloplasty, left atrium Maze procedure, left atrial plication, and LAA closure using a LAA clip. The blood pressure of the patient dropped after closing the pericardium post-operatively. Coronary artery angiography (CAG) confirmed 90% stenosis at the left coronary main trunk (LMT) origin. Percutaneous coronary intervention (PCI) was performed, and the haemodynamics settled.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The distance from the anterior wall of the LAA ostium to the LMT can be a risk for AtriClip-induced LMT compression. A different surgical strategy, such as internal sutures or surgical stapler for LAA closure, should be considered under such a condition. Selecting an appropriately sized AtriClip is essential while using the clip, placing it close to the orifice, and visually checking for compression after insertion to prevent LMT stenosis. When LMT compression by the clip was confirmed, levelling the endocardial adipose tissue with the LAA landing zone, cutting and removing the clip or coronary artery bypass grafting during operation, and PCI during CAG should be considered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad595","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T05:14:40Z","timestamp":1700889280000},"source":"Crossref","is-referenced-by-count":0,"title":["Strategies for managing left main trunk compression by left atrial appendage clip: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5851-2736","authenticated-orcid":false,"given":"Atsuyuki","family":"Mitsuishi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Kochi Medical School Hospital , 185-1, Kohasu, Okohcho , Nankoku-shi 783-8505, Kochi Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kochi Medical School Hospital , 185-1, Kohasu, Okohcho , Nankoku-shi 783-8505, Kochi Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujiro","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kochi Medical School Hospital , 185-1, Kohasu, Okohcho , Nankoku-shi 783-8505, Kochi Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics, Kochi Medical School Hospital , Nankoku-shi , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Furushima","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics, Kochi Medical School Hospital , Nankoku-shi , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"2024030519554974400_ytad595-B1","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1056\/NEJMoa2101897","article-title":"Left atrial appendage occlusion during cardiac surgery to prevent stroke","volume":"384","author":"Whitlock","year":"2021","journal-title":"N Engl J Med"},{"key":"2024030519554974400_ytad595-B2","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/icvts\/ivz156","article-title":"Outcomes of left atrial appendage occlusion using the AtriClip device: a systematic review","volume":"29","author":"Toale","year":"2019","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2024030519554974400_ytad595-B3","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.hrthm.2022.03.008","article-title":"Adverse events associated with the AtriClip device for left atrial appendage occlusion: a Food and Drug Administration MAUDE database study","volume":"19","author":"Contractor","year":"2022","journal-title":"Heart Rhythm"},{"key":"2024030519554974400_ytad595-B4","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.hrthm.2022.11.027","article-title":"To the editor- estimated prevalences of serious adverse events associated with the AtriClip device for left atrial appendage occlusion","volume":"20","author":"Kaba","year":"2023","journal-title":"Heart Rhythm"},{"key":"2024030519554974400_ytad595-B5","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.1016\/j.jcin.2021.01.018","article-title":"Acute compressive coronary artery disease due to left atrial appendage epicardial occlusion","volume":"14","author":"Mhanna","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2024030519554974400_ytad595-B6","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/jocs.15222","article-title":"Left atrial appendage occlusion device causing coronary obstruction: a word of caution","volume":"36","author":"Kuzmin","year":"2021","journal-title":"J Card Surg"},{"key":"2024030519554974400_ytad595-B7","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1016\/j.athoracsur.2019.12.039","article-title":"Surgical options to tackle coronary artery kinking in thoracoscopic left atrial appendage clipping","volume":"110","author":"Chaldoupi","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2024030519554974400_ytad595-B8","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jacep.2019.09.011","article-title":"Imaging integration to localize and protect the left coronary artery in patients undergoing LAAEI","volume":"6","author":"Romero","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2024030519554974400_ytad595-B9","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1002\/ca.23242","article-title":"Blood vessels and myocardial thickness within the left atrial appendage 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