Surgical left atrial appendage occlusion during cardiac surgery: A systematic review and meta-analysis

查看全文 作　　者：Varunsiri [1]Atti;Mahesh Anantha-[2]Narayanan;Mohit K [3]Turagam;Scott [4]Koerber;Sunil [5]Rao;Juan FViles-[6]Gonzalez;Rakesh [7]MSuri;Poonam [8]Velagapudi;Dhanunjaya [9]Lakkireddy;David G [2]Benditt

机构地区：[1]Department of Medicine, Michigan State University-Sparrow Hospital, East Lansing, MI 48912, United States;[2]Division of Cardiovascular diseases, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States;[3]Helmsley Electrophysiology Center, Icahn School of medicine at Mount Sinai, New York City, NY 10029, United States;[4]Department of Cardiac Electrophysiology, Medical University of South Carolina, Charleston, SC 29425, United States;[5]Department of Cardiovascular diseases, Genesys Heart Institute, Ascension Genesys Hospital, Grand Blanc, MI.;[6]Baptist Health South Florida, Professor of Medicine at Wertheim College of Medicine, Miami, FL 33176.;[7]Cleveland Clinic Foundation and Cleveland Clinic Abu Dhabi, Department of Thoracic and Cardiovascular Surgery. Cleveland Clinic, Cleveland, OH 44195, United States;[8]Structural Heart and Valve Center, Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center, New York City, NY 10027, United States;[9]Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, MO 64132, United States

出　　处：《World Journal of Cardiology》索引2018年第10卷第11期,共8页

基　　金：Supported by no external funding.Dr.Benditt is supported in part by a grant from the Dr.Earl E Bakken family in support of heart-brain research 摘　　要：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 31 st 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 allcause 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. 关键词：左 atrial 附器左 atrial 附器吸藏插子的事件击不利事件

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Surgical left atrial appendage occlusion during cardiac surgery: A systematic review and meta-analysis

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