Introduction:
Epicardial exclusion of LAA has gained increasing popularity since its
introduction in 2009. However, there are single center studies of this
technique for standalone stroke risk reduction in patients with
AF.1-3 While the clip has demonstrated a success rate
ranging from 93.9-100% in excluding the LAA, one significant
complication is incomplete exclusion due to residual stump greater than
1 cm as a result of clip being deployed too distally.1We describe here a solution to that complication, which is the first
reported case of implanting a second clip underneath the first clip to
obliterate the residual stump.