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

Abstract

We congratulate Mohamed et al1 on their meta-analysis of randomized controlled trials (RCTs) comparing surgical left atrial appendage occlusion (LAAO) to no LAAO in patients with atrial fibrillation (AF). The pooled estimate of a 33% reduction in risk of stroke or systemic embolism with LAAO (5 trials, 5,128 patients, risk ratio [RR] 0.67, 95% confidence interval [CI] 0.53 to 0.84, p < 0.01), largely driven by the Left Atrial Appendage Occlusion Study (LAAOS) III2 trial results, adds a higher degree of certainty to the protection against thromboembolic events provided by LAAO.