The PHRI-led trial, LAAOS III, has made the list of top advances in cardiology by several experts.
Writing for Medscape, John Mandrola’s Top 10 Cardiology Stories of 2021 includes:
“Surgical Left Atrial Appendage Closure Shines
The LAAOS III trial studied the stroke preventive effects of add-on surgical closure of the left atrial appendage (LAA) in patients with a history of atrial fibrillation (AF) who were having cardiac surgery. More than 2000 patients were randomly assigned to undergo add-on surgical closure or just have their assigned cardiac surgery. Both groups received standard care—including oral anticoagulation. Surgical LAA closure resulted in a statistically significant 2.2% absolute risk reduction in stroke or systemic embolism. There was no increase in bleeding and only 6 minutes of extra pump time.
LAAOS III gets my vote for the most important trial of the year. The benefits were clinically significant and statistically robust. When our patients with AF go for heart surgery, the surgeon should close their appendage according to the techniques used in LAAOS III—which mostly entailed excision and primary closure.
LAAOS III is a ‘practice changer”
Also in Medscape, Robert Harrington and Michael C. Gibson discuss their Top Cardiology Trials of 2021,. Their recorded video chat includes:
Harrington: “…LAAOS III, the left atrial appendage occlusion trial. Wow, that that was a clever design — well designed, well powered…”
Gibson: “Yeah. Closing off that left atrial appendage at the time of surgery reduced the risk for embolic events by one third, as I recall. I think it is important. I think LAAOS III probably should change practice.”
Cardiology Today asked members of its Editorial Board to expound on what they thought were some of the top stories of the year in the field; LAAOS III was highlighted more than once.
Matthew W. Martinez, Morristown Medical Center, wrote:
“Among developments not related to COVID-19, the most important included the results of the LAAOS III trial, which found that among patients with AF who underwent cardiac surgery, concomitant closure of the left atrial appendage reduced risk for ischemic stroke and systemic embolism.”