Evidence map›Paper›PMID 42089094›Full record

ArticleJournal of arrhythmia2026

Prophylactic Left Atrial Appendage Occlusion During Mitral Valve Repair in Patients Without Atral Fibrillation: A Meta-Analysis of Time to Event Data.

Ahmed Emara, Ameer Awashra, Mohamed S Elgendy, Mohamed R Murad, Mohamed Emara, Abubakar Nazir, Abdalhakim Shubietah, Michael Megaly, Vinayak N Bapat

Abstract read
In one paragraph

Article in Journal of arrhythmia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Left Atrial Appendage Occlusion in Cancer-Associated Atrial Fibrillation: Who, When, and How to Manage Antithrombotic Therapy.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ahmed EmaraFaculty of Medicine Al-Azhar University Cairo Egypt.ORCID https://orcid.org/0009-0001-2718-8627
Ameer AwashraDepartment of Medicine An Najah National University Nablus Palestine.ORCID https://orcid.org/0009-0002-5122-8200
Mohamed S ElgendyFaculty of Medicine Tanta University Tanta Egypt.ORCID https://orcid.org/0000-0003-3080-2875
Mohamed R MuradFaculty of Medicine Al-Azhar University Cairo Egypt.
Mohamed EmaraFaculty of Medicine Al-Azhar University Cairo Egypt.
Abubakar NazirDepartment of Medicine Mercy Health-The Jewish Hospital Cincinnati Ohio USA.
Abdalhakim ShubietahDepartment of Medicine Advocate Illinois Masonic Medical Center Chicago Illinois USA.ORCID https://orcid.org/0000-0002-8300-0262
Michael MegalyIntegris Health Heart Hospital Oklahoma City Oklahoma USA.
Vinayak N BapatDepartment of Cardiac Surgery, Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis Minnesota USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Mitral valve repair (MVr) is effective for mitral regurgitation, but the benefit of prophylactic left atrial appendage occlusion (LAAO) in patients without prior atrial fibrillation (AF) remains unclear. This meta-analysis aimed to assess the long-term safety and efficacy of LAAO in this understudied population. Methods: We performed a meta-analysis from four major databases until December 2025. Kaplan-Meier curves data were reconstructed and analyzed using Cox regression models and hazard ratios (HR) for thromboembolic events (mainly stroke). A random-effects meta-analysis was performed with R software to calculate risk ratios (RR), hazard ratios (HR), and mean differences (MD), all with 95% confidence intervals (CIs). Results: Three studies with 5048 patients were included. LAAO was associated with a significant reduction in thromboembolic risk at 5 years (HR 0.60, 95% CI 0.46 to 0.77). LAAO reduced in-hospital stroke (RR 0.43, 95% CI 0.25 to 0.72) but increased postoperative AF (RR 1.17, 95% CI 1.09 to 1.26). No significant differences were observed in 30-day mortality (RR 0.56, 95% CI 0.07 to 4.33) or hospital stay (MD -0.16 days, 95% CI - 0.48 to 0.16). Conclusions: Prophylactic LAAO during MVr in patients without AF may reduce thromboembolic events risk but appears to increase postoperative AF. Further randomized studies are warranted.

Indexed as

atrial fibrillationleft atrial appendage occlusionmitral valve repair

Identifiers

PMID42089094
PMCPMC13136685

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.