{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:17:38Z","timestamp":1791422258688,"version":"4.3.3"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Most strokes associated with atrial fibrillation (AF) result from left atrial appendage thrombi. Oral anticoagulation can reduce stroke risk but is limited by complication risk and non-compliance. Left atrial appendage exclusion (LAAE) is a new surgical option to reduce stroke risk in AF. The study objective was to evaluate the safety and feasibility of standalone thoracoscopic LAAE in high stroke risk AF patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This was a retrospective, multicentre study of high stroke risk AF patients who had oral anticoagulation contraindications and were not candidates for ablation nor other cardiac surgery. Standalone thoracoscopic LAAE was performed using 3 unilateral ports access and epicardial clip. Periprocedural adverse events, long-term observational clinical outcomes and stroke rate were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Procedural success was 99.4% (174\/175 patients). Pleural effusion occurred in 4 (2.3%) patients; other periprocedural complications were &amp;lt;1% each. One perioperative haemorrhagic stroke occurred (0.6%). No phrenic nerve palsy or cardiac tamponade occurred. Predicted annual ischaemic stroke rate of 4.8\/100 patient-years (based on median CHA2DS2-VASc score of 4.0) was significantly higher than stroke risk observed in follow-up after LAAE. No ischaemic strokes occurred (median follow-up: 12.5\u2009months), resulting in observed rate of 0 (95% CI 0\u20132.0)\/100 patient-years (P\u2009&amp;lt;\u20090.001 versus predicted). Six all-cause (non-device-related) deaths occurred during follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Study proved that a new surgical option, standalone thoracoscopic LAAE, is feasible and safe. With this method, long-term stroke rate may be reduced compared to predicted for high-risk AF population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab334","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T12:07:29Z","timestamp":1637582849000},"page":"548-555","source":"Crossref","is-referenced-by-count":26,"title":["Standalone epicardial left atrial appendage exclusion for thromboembolism prevention in atrial fibrillation"],"prefix":"10.1093","volume":"34","author":[{"given":"Richard","family":"Cartledge","sequence":"first","affiliation":[{"name":"Cardiovascular and Thoracic Surgery, Lynn Heart and Vascular Institute Baptist Health South Florida Boca Raton Regional Hospital, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Suwalski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Military Institute of Medicine, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8188-0422","authenticated-orcid":false,"given":"Anna","family":"Witkowska","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Cardiovascular and Thoracic Surgery, Lynn Heart and Vascular Institute Baptist Health South Florida Boca Raton Regional Hospital, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Cioci","sequence":"additional","affiliation":[{"name":"Florida Atlantic University College of Medicine, Boca Raton, FL, 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