ReviewJournal of the Society for Cardiovascular Angiography & Interventions2026
Surgical Left Atrial Appendage Occlusion During Cardiac Surgery in Atrial Fibrillation: A Contemporary Systematic Review and Meta-Analysis.
Review in Journal of the Society for Cardiovascular Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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9 authors.
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Abstract
Background: Left atrial appendage occlusion (LAAO) has emerged as a promising adjunctive strategy for stroke prevention in patients with atrial fibrillation (AF) undergoing cardiac surgery. While previous studies have assessed its efficacy, a comprehensive evaluation integrating both randomized controlled trials and observational data remains limited. Methods: We conducted a systematic review and meta-analysis to evaluate the safety and effectiveness of LAAO compared with no LAAO in patients with AF undergoing cardiac surgery. A total of 20 studies (12 observational and 8 randomized controlled trials) encompassing 215,181 patients treated between 2005 and 2024 were included. Pooled odds ratios with 95% CIs were calculated using fixed- and random-effects models for primary and secondary outcomes, with heterogeneity, publication bias, and sensitivity analyses performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Left atrial appendage occlusion was associated with a significant reduction in ischemic stroke (odds ratio, 0.72; 95% CI, 0.66-0.79), systemic embolism, hemorrhagic stroke, silent cerebral infarcts, and cardiac death. A significant reduction in all-cause mortality was observed using a fixed-effects model, but not with the random-effects model due to substantial heterogeneity. No significant differences were observed in myocardial infarction, peripheral ischemia, or major bleeding events. Sensitivity and cumulative analyses supported the robustness of the ischemic stroke findings. Subgroup analyses revealed no significant variation in outcomes based on study design or publication year. Conclusions: Left atrial appendage occlusion during cardiac surgery is associated with a significant reduction in thromboembolic events, without increasing the risk of major complications. These findings support the role of LAAO as a safe and effective adjunctive intervention in appropriately selected patients with AF. Further high-quality, prospective studies are warranted to confirm these benefits and inform guideline-directed practice.
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