Alas, the Return of the Lasso

Abstract

Independent of the imperative to surgically treat concomitant atrial fibrillation, surgeons should close the left atrial appendage (LAA). The Left Atrial Appendage Occlusion Study (LAAOS III)1 is the third installment of the arduous march to establish the effect of LAA closure during cardiac surgery in atrial fibrillation patients. For many, leaving a patent LAA in an atrial fibrillation patient is to turn our backs on clear evidence revealing that the LAA is a persistent danger. We know that standard of care does not translate into lifelong anticoagulation compliance.