Surgical left atrial appendage occlusion during cardiac surgery: A systematic review and meta-analysis
| Autor: | David G. Benditt, Juan F. Viles-Gonzalez, Dhanunjaya Lakkireddy, Sunil V. Rao, Poonam Velagapudi, Mahesh Anantha-Narayanan, Mohit K. Turagam, Rakesh M. Suri, Varunsiri Atti, Scott Koerber |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Left atrial appendage 030204 cardiovascular system & hematology Left atrial appendage occlusion 03 medical and health sciences 0302 clinical medicine Internal medicine medicine cardiovascular diseases 030212 general & internal medicine Adverse effect Stroke business.industry medicine.disease Cardiac surgery Embolic events Meta-analysis Adverse events cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business Meta-Analysis |
| Zdroj: | World Journal of Cardiology |
| ISSN: | 1949-8462 |
| Popis: | AIM To evaluate the safety and efficacy of surgical left atrial appendage occlusion (s-LAAO) during concomitant cardiac surgery. METHODS We performed a comprehensive literature search through May 31st 2018 for all eligible studies comparing s-LAAO vs no occlusion in patients undergoing cardiac surgery. Clinical outcomes during follow-up included: embolic events, stroke, all-cause mortality, atrial fibrillation (AF), reoperation for bleeding and postoperative complications. We further stratified the analysis based on propensity matched studies and AF predominance. RESULTS Twelve studies (n = 40107) met the inclusion criteria. s-LAAO was associated with lower risk of embolic events (OR: 0.63, 95%CI: 0.53-0.76; P < 0.001) and stroke (OR: 0.68, 95%CI: 0.57-0.82; P < 0.0001). Stratified analysis demonstrated this association was more prominent in the AF predominant strata. There was no significant difference in the incidence risk of all-cause mortality, AF, and reoperation for bleeding and postoperative complications. CONCLUSION Concomitant s-LAAO during cardiac surgery was associated with lower risk of follow-up thromboembolic events and stroke, especially in those with AF without significant increase in adverse events. Further randomized trials to evaluate long-term benefits of s-LAAO are warranted. |
| Databáze: | OpenAIRE |
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