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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Concomitant LAA Closure during Cardiac Surgery-Update 2025

Sören Schenk1, Simon Pecha2, Nicolas Doll3

  • 1Department of Cardiac Surgery, Sana Herzzentrum Cottbus, Herzchirurgie, Cottbus, Germany.

The Thoracic and Cardiovascular Surgeon
|April 15, 2025
PubMed

Insights

Atrial fibrillation increases stroke risk. Closing the left atrial appendage (LAA) during heart surgery is recommended to prevent these neurological events, especially in patients with preoperative atrial fibrillation.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) significantly elevates the risk of embolic strokes.
  • AF affects approximately 25% of patients undergoing cardiac surgery.
  • Left atrial appendage (LAA) closure is a recognized strategy to mitigate stroke risk.

Purpose of the Study:

  • To evaluate the current clinical evidence regarding LAA closure in cardiac surgery patients.
  • To provide recommendations for the management of LAA in patients with preoperative atrial fibrillation.

Main Methods:

  • Review of current clinical research on LAA closure.
  • Analysis of guidelines from major cardiovascular societies (ESC/EACTS).

Main Results:

  • LAA closure is a class IB recommendation for AF patients according to recent ESC/EACTS guidelines.
  • Concomitant LAA closure effectively reduces the risk of neurological events.

Conclusions:

  • The working group "Heart Rhythm Disorders" of the DGTHG supports LAA closure.
  • Routine LAA closure is recommended for patients with preoperative atrial fibrillation undergoing heart surgery.

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