Background
Thromboembolic (TE) events are among the most common and devastating adverse events in patients with continuous‐flow left ventricular assist device (cf‐LVAD). Given the high burden of AF among cf‐LVAD patients, we sought to evaluate the effect of concomitant surgical LAAO in patients receiving cf‐LVAD.
Methods
A systematic search using electronic databases was performed using the keywords: “left atrial appendage occlusion” and “left ventricular assist device.” Statistical analysis was performed using metapackage for R version 4.0 and Rstudio version 1.2. Mantel–Haenszel risk ratio (RR) random‐effects model was used to summarize data between two groups. The primary outcomes included: (a) stroke; (b) LVAD pump thrombosis; (c) all‐cause mortality
Results
Three studies with a total of 305 patients (LAAO = 68 and No‐LAAO = 237) were included in the analysis. HeartMate II (39%) and Heartware (27.5%) were the two most common cf‐LVADs utilized, while only 5% received HeartMate III. At a mean follow up of 1.47 years, LAAO group had a lower risk of stroke (8.8% vs. 15.2%, RR 0.64; 95% CI 0.28–1.49), LVAD pump thrombosis (1.5% vs. 3.8%, RR 0.28; 95% CI 0.05–1.55) and all‐cause mortality (5.9% vs. 20.2%, RR 0.69; 95% CI 0.19–2.52) when compared with no‐LAAO group, but the difference did not reach statistical significance.
Conclusion
Concomitant surgical LAAO at the time of cf‐LVAD implantation demonstrated a trend toward positive outcomes and was not associated with adverse outcomes during the follow‐up period, though the results were not statistically significant