ReviewFrontiers in cardiovascular medicine2026
Systematic evaluation and meta-analysis of transcardiac intracavitary and transesophageal echocardiography-guided left atrial appendage occlusion surgery.
Review in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To systematically evaluate the differences in safety, efficacy, and economics between intracardiac ultrasound (ICE) and transesophageal echocardiography (TEE)-guided LAAO (LAAO), and to provide an evidence-based rationale for the selection of clinical image-guided modalities. Methods: PubMed, Embase, Cochrane Library, Web of Science and Wanfang databases were searched to include randomized controlled trials and observational studies comparing ICE with TEE-guided LAAO, strictly following PRISMA guidelines. Two investigators independently screened the literature, extracted data and assessed the risk of bias (ROBINS-I and Cochrane tools). Meta-analysis was performed using RevMan 5.4.1, and the outcome indicators included technical success, procedure time, contrast dose, fluoroscopy time, complications, and economic parameters, and subgroup analyses were performed to explore the effects of factors such as patient characteristics and instrument type. Results: A total of 16 studies were included.There was no significant difference between ICE and TEE in terms of technical success (RR = 1.01,95% CI 1.00-1.02, Operative efficiency: ICE significantly reduced operative time in the subgroups of single-center studies (MD = -7.28 min, 95% CI: -9.46 to -5.10, Disease characteristics: In the subgroup with a hypertension proportion <90%, ICE shortened both operative time (MD = -12.00 min, 95% CI: -15.08 to -8.92, Economics: ICE reduced professional/anesthesia-related costs (MD = -$2,654, Conclusion: The core clinical outcomes (success and safety) of ICE and TEE in LAAO are equivalent, but operational efficiency is moderated by patient age, LV morphology, and device design. ICE is recommended for young, anatomically simple patients at high risk for anesthesia, and individualized decision-making needs to be optimized with team experience and health economic assessment. Future multicenter RCTs and cost-utility analyses are needed to validate long-term benefits. Systematic Review Registration: PROSPERO CRD42024626272.
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