Different Techniques of Surgical Left Atrial Appendage Closure and Their Efficacy: A Systematic Review

Background: Atrial fibrillation has been identified as an independent risk factor for thromboembolic events. Since 1948 different surgical techniques have described the feasibility and rationale of left atrial appendage closure. The aim this systematic review is to evaluate reported patency rates techniques. Methods: This was conducted according preferred reporting items reviews meta-analyses (PRISMA) guidelines. Two investigators searched PubMed, Scopus, Web Science, Cochrane Central Register Controlled Trials, OVID® (Wolters Kluwer, Alphen aan den Rijn, Netherlands) identify relevant studies. Consecutively, a PICO (Population, Intervention, Comparison Outcomes) strategy assessment literature performed search eventual other studies that may ignored. Results: A total 42 were included in our analysis. number patients who underwent closure 5671, 61.2% imaging follow up performed, mostly with transesophageal echocardiographic evaluation. Success rate was: Clip deployment 98%; Lariat procedure 88%; Surgical amputation 91%; Endocardial suture 74.3%, Epicardial 65%; Left (LAAC) ligation 60.9%; Stapler technique excision (LAA) 100%; without 70%. Conclusions: To date, data on are poor not standardized, even if acceptable comparable transcatheter procedures. If validated large-scale non-retrospective multicentric studies, these promising developments offer valuable alternative (AF) ineligible oral anticoagulation therapy.