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Background <p>The left atrial appendage (LAA) is the origin of thrombi in patients with atrial fibrillation (AF). Various techniques are available for surgical LAA occlusion. Current guidelines recommend surgical LAA closure as concomitant procedure in patients undergoing cardiac surgery or endoscopic or hybrid ablation for AF.</p> Objectives <p>This review article summarizes the current scientific evidence regarding surgical LAA closure and provides an outlook into its potential role in the future.</p> Materials and methods <p>A&#xa0;literature review was performed for LAA closure, indications, techniques, clinical outcomes, and ongoing studies.</p> Results <p>Different techniques are performed for surgical LAA closure. In a&#xa0;large randomizes study surgical LAA closure was associated with a&#xa0;reduction in thromboembolism in patients with AF. There are ongoing studies that examine the potential role of surgical LAA closure in patients with sinus rhythm and increased risk for stroke.</p> Conclusions <p>Surgical closure as a&#xa0;concomitant procedure in patients with AF undergoing cardiac surgery is now well established. It is unclear whether these patients require anticoagulation after successful closure. Currently, a&#xa0;few randomized trials are ongoing to evaluate whether prophylactic surgical LAA closure in patients with sinus rhythm and increased risk for stroke effectively reduces the incidence of stroke. At present, there are no data that support surgical LAA closure in patients with sinus rhythm and low risk for stroke.</p>

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Chirurgischer Verschluss des linken Vorhofohrs zur Thrombembolieprophylaxe

  • 期刊论文

  • 发表日期：

    2025年5月30日

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  • Ioana Geisler,
  • Thomas Pühler,
  • Stephan Ensminger,
  • Buntaro Fujita

摘要

Background

The left atrial appendage (LAA) is the origin of thrombi in patients with atrial fibrillation (AF). Various techniques are available for surgical LAA occlusion. Current guidelines recommend surgical LAA closure as concomitant procedure in patients undergoing cardiac surgery or endoscopic or hybrid ablation for AF.

Objectives

This review article summarizes the current scientific evidence regarding surgical LAA closure and provides an outlook into its potential role in the future.

Materials and methods

A literature review was performed for LAA closure, indications, techniques, clinical outcomes, and ongoing studies.

Results

Different techniques are performed for surgical LAA closure. In a large randomizes study surgical LAA closure was associated with a reduction in thromboembolism in patients with AF. There are ongoing studies that examine the potential role of surgical LAA closure in patients with sinus rhythm and increased risk for stroke.

Conclusions

Surgical closure as a concomitant procedure in patients with AF undergoing cardiac surgery is now well established. It is unclear whether these patients require anticoagulation after successful closure. Currently, a few randomized trials are ongoing to evaluate whether prophylactic surgical LAA closure in patients with sinus rhythm and increased risk for stroke effectively reduces the incidence of stroke. At present, there are no data that support surgical LAA closure in patients with sinus rhythm and low risk for stroke.