Ligation of the left atrial appendage with surgical stapler

The elimination of the left atrial appendage during cardiac surgery is an alternative to oral anticoagulation in patients with atrial fibrillation. This is traditionally done by resecting the appendage and closing the atrium using non-absorbable sutures. We use a TX 30V stapler (Ethicon, Somerville, NJ, US) to close the appendage, which facilitates the alignment of the staple line with the base of the appendage and delivers three staggered rows of titanium staples in 30mm. A similar method had been reported previously ¹ although it is not widely used. We think this is a safe, effective and easy way to ligate the appendage during cardiac operations.