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April 1, 2026Journal of Clinical MedicineOpen Access

Transfusion before and after LAAC linked to a ~6-fold increase in mortality risk.

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Why the study?

Does left atrial appendage closure (LAAC) reduce bleeding events, and how do post-procedural transfusion requirements affect mortality in patients with nonvalvular atrial fibrillation?

Population

70 consecutive patients who underwent successful LAAC with the Watchman device

Design

Single-center retrospective study

Follow-up

Mean 1210 days

Key result

Transfusion requirements before and after left atrial appendage closure were independently associated with a six-fold increase in mortality risk (HR = 5.97).

Authors

MBManuella BogdanBPBalázs PolgárEZElőd János Zsigmond

Discussion

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Member takes

Overview

May warrant intensified bleeding prevention around LAAC; extends observational data but leaves open impact on long-term mortality.

Key Points

  • Analyze the impact of bleeding events and blood transfusions on mortality after left atrial appendage closure.
  • Conducted a single-center retrospective study with 70 patients who underwent LAAC.
  • Evaluated acute procedural outcomes and long-term thromboembolic and bleeding events.
  • Followed patients for an average of 1210 days post-procedure.
  • Achieved a procedural success rate of 98.6% with low complication rates.
  • Significant reduction in bleeding events was observed post-LAAC.
  • 42.9% of patients required hospitalization for bleeding within 6 months.
  • Overall mortality was 40%, with bleeding-related transfusions linked to a six-fold increased mortality risk.

Structured PICO

Does left atrial appendage closure (LAAC) reduce bleeding events, and how do post-procedural transfusion requirements affect mortality in patients with nonvalvular atrial fibrillation?

P
Population
Patients with nonvalvular atrial fibrillation at high risk of thromboembolic events or bleeding complications
I
Intervention
Left atrial appendage closure (LAAC) with the Watchman device
C
Comparator
Pre-procedural state (historical self-control for bleeding events)
O
Outcome
Acute procedural outcomes, long-term thromboembolic and bleeding events, transfusion requirements, and mortalityhard clinical

While LAAC reduces overall bleeding burden, persistent postprocedural bleeding requiring red blood cell transfusion is strongly associated with increased long-term mortality.

Limitations

  • Single-center design
  • Retrospective study

Cite This Study

Bogdan et al. (2026) studied this question. Transfusion requirements before and after left atrial appendage closure were independently associated with a six-fold increase in mortality risk (HR = 5.97).

synapsesocial.com/papers/69ccb63f16edfba7beb87ec9https://doi.org/10.3390/jcm15072626
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Less major bleeding and higher hemoglobin after left atrial appendage closure in high‐risk patients: Data from a long‐term, longitudinal, two‐center observational study2023 · 5 citations
  2. 2Long-Term Efficacy and Safety of Left Atrial Appendage Closure Procedures2023 · 1 citations
  3. 3Post-Approval U.S. Experience With Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation2016 · 258 citations
  4. 4Left atrial appendage closure in atrial fibrillation patients with prior major bleeding or ineligible for oral anticoagulation2019 · 7 citations
  5. 5Should left atrial appendage closure be considered in resistant left atrial appendage thrombus cases? ‘Former Foe, New Ally’2024 · 2 citations