1666 – Exclusion of the left atrial appendage via surgical epicardial clip implantation concomitant to open cardiac surgery for patients with atrial fibrillation

Advice to Prostheses List Advisory Committee for inclusion on the Prostheses List.

Implantation of an epicardial clip producing exclusion of the left atrial appendage, concomitant to open cardiac surgery. The left atrial appendage is sized via direct measurement, then the device is placed under direct visualisation at the base of the left atrial appendage, resulting in electrical and haemodynamic isolation from the left atrium. Implantation will occur concomitant to open cardiac surgery, most commonly valvular replacement/repair surgery and Coronary artery bypass grafting.

Type: Therapeutic

Atrial fibrillation is a key risk factor for ischaemic strokes.It is the most common sustained cardiac arrhythmia. Thrombus may form when blood becomes trapped in the left atrial appendage due to the fibrillation, effectively causing intermittent stasis of the blood. As the thrombus is in the systemic circulation downstream of the cerebral vasculature, it may migrate the arterial system to the cerebral circulation and cause ischaemic stroke via occlusion of a cerebral artery

• PASC consultation: Closed
• MSAC consultation:  TBA – please subscribe to the MSAC bulletin to be notified when consultation opens for this application

• PASC meeting: 12 to 13 August 2021
• ESC meeting: -
• MSAC meeting: -