ReviewJournal of the Society for Cardiovascular Angiography & Interventions2026
Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement: A 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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10 authors.
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Abstract
Background: Atrial fibrillation (AF) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR) and increases risks of thromboembolism and bleeding with chronic anticoagulation. Concomitant left atrial appendage occlusion (LAAO) during TAVR may reduce long-term stroke and bleeding risks. Methods: PubMed, Embase, and Cochrane databases were searched through May 2025 for studies comparing TAVR + LAAO versus TAVR + standard medical therapy in patients with atrial fibrillation. Random-effects models were used to pool risk ratios (RRs) or mean differences with 95% CIs. Results: Four studies (2 randomized controlled trials, 2 observational; n = 563, mean age 82 years) were included; 279 patients (49.5%) underwent TAVR + LAAO. Thirty-day outcomes showed no differences in mortality (RR 0.91; 95% CI, 0.28-3.01), stroke/transient ischemic attack (RR 0.27; 95% CI, 0.04-1.66), or major bleeding (RR 0.27; 95% CI, 0.04-1.66). Over a 9.8-month to 2-year follow-up, all-cause mortality (RR 0.95; 95% CI, 0.68-1.32), cardiac death (RR 0.95; 95% CI, 0.60-1.50), stroke/transient ischemic attack (RR 1.33; 95% CI, 0.30-5.83), and major bleeding (RR 1.06; 95% CI, 0.71-1.59) remained similar. Contrast use and hospital length of stay were comparable. Conclusions: Concomitant TAVR plus LAAO appears feasible, with no statistically significant differences in short-term outcomes versus TAVR plus standard medical therapy; however, certainty is low, and findings are hypothesis-generating, warranting larger randomized trials and prospective registries.
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