Methods and Criteria for Evaluating the Success of Surgical Left Atrial Appendage Closure: A Systematic Review

This systematic review of 80 studies (7,517 patients; 10,375 imaging examinations) examined how success is assessed after surgical left atrial appendage closure. Transesophageal echocardiography dominated intraoperative assessment (83 percent), while cardiac computed tomography (CT) featured in postoperative evaluation (44 percent). Seventeen distinct success definitions emerged, most commonly absence of residual flow and a stump under 10 mm. Overall success was 92.8 percent, peaking intraoperatively (96.8 percent) and declining over time. The authors highlight marked heterogeneity and call for standardized criteria to improve comparability.