Perioperative Outcomes of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery

Surgical left atrial appendage occlusion (S-LAAO) is increasingly performed during cardiac surgery, but perioperative outcomes remain uncertain. Using a nationwide Japanese inpatient database, we analyzed 25,059 adults undergoing valve or coronary bypass surgery (2020 - 2022). After propensity score matching (n = 2,543 each), addition of S-LAAO was not associated with differences in in-hospital mortality, transfusion, reoperation, or 30-day readmission compared to non-S-LAAO group. However, prolonged inotropic support (≥ 2 days) was more frequent with S-LAAO (40.8% vs. 34.7%; odds ratio 1.29, 95% confidence interval: 1.13 - 1.47). Addition of S-LAAO did not increase mortality but was linked to greater inotrope use, warranting further investigation.