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Published on: February 26, 2013
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Outcomes of Left Atrial Appendage Patency After Device Closure Detected by Cardiac CT: A Meta-Analysis
Xander Jacquemyn1, Michel Pompeu Sá2, Kasper Korsholm3
1Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
JACC. Cardiovascular Imaging
|September 9, 2025
Summary
Residual leaks after left atrial appendage occlusion (LAAO) are common. Left atrial appendage patency significantly increases thromboembolism risk, suggesting CT-detected leaks are clinically significant.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Residual leaks are a frequent complication following left atrial appendage occlusion (LAAO).
- The clinical significance of these residual leaks requires further elucidation.
Purpose of the Study:
- To systematically evaluate the prognostic implications of residual left atrial appendage (LAA) patency and peridevice leaks (PDLs).
- To assess the association of LAA patency and PDLs detected by cardiac computed tomography (CT) with thromboembolism risk post-LAAO.
Main Methods:
- A meta-analysis of 17 studies including 2,036 patients was performed.
- Bayesian statistical methods were employed to assess the probability of increased risks associated with residual leaks.
Main Results:
- Left atrial appendage patency was significantly associated with a nearly 2-fold increased odds ratio (OR) of thromboembolism (pooled OR: 1.87).
- Peridevice leaks (PDLs) showed a trend towards increased risk but did not reach statistical significance (pooled OR: 1.50).
- The posterior probability of a positive absolute risk difference for LAA patency was 98.5%.
Conclusions:
- Left atrial appendage patency and PDLs detected by CT following LAAO may be linked to an elevated risk of thromboembolism.
- These findings suggest that residual leaks identified by CT are clinically significant and warrant careful consideration.
