LAAOS 3
Description
The goal of the trial was to evaluate surgical left atrial appendage occlusion compared with no occlusion among patients with atrial fibrillation undergoing open-heart surgery.
In this trial, 4770 patients on anticoagulation therapy for over 3 years with atrial fibrillation with CHA2DS2-VASc ≥2, were randomized to undergo open-heart surgery with or without left atrial appendage occlusion
In results:
The primary outcome of ischemic stroke or systemic embolism after 3.8 years occurred in 4.8% of the occlusion group compared with 7.0% of the no occlusion group with a significance of 0.001
In the Secondary outcomes, the event of Ischemic stroke was also significantly lesser to the non-occlusion arm.
Among patients with atrial fibrillation undergoing cardiac surgery, left atrial appendage occlusion was found to be superior to no occlusion.
More benefit was observed when the results were landmarked at 30 days versus <30 days.
Major bleeding was similar between the treatment groups.
Thus to conclude the benefit of surgical left atrial appendage occlusion appeared to be additive to anticoagulation therapy; therefore, this trial does not support surgical left atrial appendage occlusion as a replacement to anticoagulation therapy.
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United States
