Meta-Analysis Evaluating Outcomes of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery

Area of Science:

• Cardiology
• Cardiac Surgery
• Interventional Cardiology

Background:

• Surgical left atrial appendage occlusion (S-LAAO) is increasingly performed during cardiac surgery.
• Evidence supporting the efficacy of S-LAAO remains inconclusive, necessitating further investigation.

Purpose of the Study:

• To evaluate the effectiveness of S-LAAO in reducing ischemic stroke, postoperative atrial fibrillation, and all-cause mortality.
• To synthesize existing evidence through a comprehensive meta-analysis.

Main Methods:

• A systematic literature review was conducted following PRISMA guidelines.
• Meta-analysis included 10 studies comprising 6,779 patients undergoing S-LAAO and 6,573 control patients.
• Outcomes assessed included ischemic stroke, postoperative atrial fibrillation, and all-cause mortality.

Main Results:

• The S-LAAO group demonstrated a significant reduction in ischemic stroke events (pooled OR 0.655, p=0.0004).
• All-cause mortality was also significantly lower in the S-LAAO cohort (pooled OR 0.74, p=0.0408).
• No significant difference in postoperative atrial fibrillation was observed between the S-LAAO and non-LAAO groups (pooled OR 1.29, p=0.2752).

Conclusions:

• S-LAAO is associated with a decreased risk of ischemic stroke or systemic embolism.
• The procedure also correlates with reduced all-cause mortality in patients undergoing cardiac surgery.
• S-LAAO does not appear to influence the incidence of postoperative atrial fibrillation.