Endoloop-Assisted Clip Ligation of the Left Atrial Appendage

This video submission is from the 2025 CTSNet Innovation Video Competition. Watch all entries from the competition, including the winning videos.   

The authors present a novel technique utilizing an endoloop to assist in the secure and efficient ligation of the left atrial appendage (LAA) using a clip-based approach. This method provides enhanced control and positioning during clip deployment, especially in anatomically challenging cases. The video demonstrates adequate exposure, endoloop application, easy mobility and retraction of the LAA using the endoloop, along with clip placement and post-ligation assessment. This technique may serve as a practical adjunct for ensuring safe LAA closure in both open and minimally invasive cardiac procedures. 

Disclosure 

Dr. Gregory Rushing serves as the clinical proctor for Atricure. Dr. Pablo F. Ruda Vega acts as the clinical proctor for both Medtronic and Atricure. None of the authors have any financial interest in the materials presented in this video.

References

1. Kimura, Takehiro et al. “Pericardial endoscopy-guided left atrial appendage ligation: a pilot study in a canine model.” Circulation. Cardiovascular interventions vol. 7,6 (2014): 844-50. doi:10.1161/CIRCINTERVENTIONS.114.001610
2. Blackshear, Joseph L et al. “Thoracoscopic extracardiac obliteration of the left atrial appendage for stroke risk reduction in atrial fibrillation.” Journal of the American College of Cardiology vol. 42,7 (2003): 1249-52. doi:10.1016/s0735-1097(03)00953-7

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