Surgical Options to Tackle Coronary Artery Kinking in Thoracoscopic Left Atrial Appendage Clipping.

To close the left atrial appendage during thoracoscopic ablation of atrial fibrillation, the use of a clipping device has proven to be an elegant and efficacious technique. Although very rare, adequate ostial appendage clipping can provoke coronary artery kinking and thus lead to cardiac ischemia. We describe a minimally invasive surgical technique to deal with this potentially serious complication.