Robotic Left Atrial Appendage Occlusion: Insights From Real-World Practice

Abstract

Objective: We report our initial cases of robotic left atrial appendage occlusion (LAAO) device deployment. Methods: From June 2021 to December 2024, all consecutive patients undergoing robotic-assisted LAAO (isolated or with robotic-assisted CABG) using an epicardial clip were enroled. The study protocol was approved by the Institutional Review Board (IRB 45CFR164.512). Results: A total of 28 patients were included, 22 of which underwent a concomitant CABG. Transesophageal echocardiogram confirmed excellent exclusion of the LA appendage in all but one patient. There were no postoperative strokes, myocardial infarctions, reoperation for bleeding, unplanned revascularisation, or deaths. At a median of 1.4 [0.9–1.8] years, there was 1 non-cardiac mortality (cancer) and 1 stroke. Nine (32.1%) patients were off OAC, while 21 (75.0%) were off class I-III antiarrhythmic drugs. Conclusions: These early results show optimal stroke prevention outcomes, considering the high-risk level of the patients. Longer follow-up is warranted to confirm these outcomes.