Meta-Analysis Evaluating Outcomes of Surgical Left Atrial Appendage Occlusion During Cardiac Surgery

Abstract Surgical left atrial appendage occlusion (S-LAAO) has become a common procedure performed in patients undergoing cardiac surgery; however, evidence to support this procedure remains inconclusive. This meta-analysis aims to assess the efficacy of S-LAAO in terms of ischemic stroke, postoperative atrial fibrillation (AF), and all-cause mortality. A thorough literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We identified ten relevant studies for our meta-analysis. It included 6779 patients who underwent S-LAAO and 6573 who did not undergo LAAO. In terms of Ischemic stroke, the S-LAAO cohort had a lower events (pooled OR: 0.655 (0.518-0.829), P = 0.0004) compared to the non-LAAO cohort. S-LAAO cohort also had lower events of all-cause mortality (pooled OR: 0.74 (95% CI 0.55-0.99), P = 0.0408) when compared to the non-LAAO cohort. In regards to postoperative AF, there was no difference between the two groups (pooled OR: 0.75 (95% CI 0.40-1.40), P = 0.3642). In conclusion, S-LAAO was associated with lower events of ischemic stroke or systemic embolism and all-cause mortality when compared to the non-LAAO group.