Journal article
Left Atrial Appendage Closure During Cardiac Surgery for Atrial Fibrillation: A Meta-Analysis
Cardiovascular revascularization medicine, Vol.40, pp.26-36
07/2022
DOI: 10.1016/j.carrev.2021.11.002
PMID: 34801420
Abstract
Left atrial appendage closure (LAAC) during cardiac surgery in atrial fibrillation (AF) patients has been investigated in multiple studies with variable safety and efficacy results.
A comprehensive review was performed of all studies comparing LAAC and placebo arm during cardiac surgery in AF patients. A random-effect model was used to calculate risk ratios, mean differences, and 95% confidence intervals.
Five randomized controlled trials and 22 observational studies were included with a total of 540,111 patients. The LAAC group had significantly decreased postoperative stroke/embolic events as compared to the no LAAC group with all cardiac surgeries (3.74% vs 4.88%, p = 0.0002), isolated valvular surgery (1.95% vs 4.48%, p = 0.002). However, CABG insignificantly favored the LAAC group for stroke/embolic events (6.72% vs 8.30%, p = 0.07). There was no difference between both groups in all-cause mortality in the perioperative period (p = 0.42), but was significantly lower in the LAAC arm after two years (14.1% vs 18.3%, p = 0.02). There was no difference in major bleeding, all-cause rehospitalizations, or cross-clamp time between both groups (p = 0.53 and p = 0.45). The bypass and the cross-clamp time were longer in the LAAC group (4 and 9 min, respectively).
In AF patients, LAAC during cardiac surgery had a decreased risk of stroke and long-term all-cause mortality. Additionally, there was no difference in major bleeding, all-cause rehospitalizations, or cross-clamp time.
•Left atrial appendage closure during cardiac surgery is safe and effective.•LAAC arm had significantly decreased postoperative stroke and all-cause mortality.•No difference in major bleeding, all-cause rehospitalizations, and cross-clamp time
Details
- Title: Subtitle
- Left Atrial Appendage Closure During Cardiac Surgery for Atrial Fibrillation: A Meta-Analysis
- Creators
- Rohan Madhu Prasad - Michigan State UniversityYehia Saleh - Houston MethodistAbdullah Al-Abcha - Michigan State UniversityOla Abdelkarim - Houston MethodistOmar M. Abdelfattah - Morristown Medical CenterMahmoud Abdelnabi - Texas Tech University Health Sciences CenterAbdallah Almaghraby - Alexandria UniversityMostafa Elwany - Alexandria UniversityElise DeBruyn - University of Illinois Urbana-ChampaignGeorge S. Abela - Michigan State University
- Resource Type
- Journal article
- Publication Details
- Cardiovascular revascularization medicine, Vol.40, pp.26-36
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.carrev.2021.11.002
- PMID
- 34801420
- ISSN
- 1553-8389
- eISSN
- 1878-0938
- Number of pages
- 11
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755392602771
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