LAACS-2Hot Line 12Cardiac Surgery
Left Atrial Appendage Closure During Cardiac Surgery
Left atrial appendage closure concomitant with cardiac surgery
Presenting authorHelena DominguezElectrophysiology · Bispebjerg University Hospital, DenmarkHelena Domínguez is Associate Professor in the Department of Biomedical Sciences at the University of Copenhagen and Research Consultant in the Department of Cardiology at Bispebjerg-Frederiksberg Hospital. She is a specialist in internal medicine and cardiology recognized by the Danish National Board in 2007. Her research includes translational studies on atrial fibrillation, left atrial appendage closure, ECG analysis, and telemedicine models for patient management.
Overview
Await trial results before routine concomitant LAA closure; LAACS-2 will clarify benefit in patients without prior AF.
Key result
Left atrial appendage closure concomitant with cardiac surgery is being evaluated in a late-breaking trial, with results currently pending.
Discussion
Expert reaction lands here the moment LAACS-2 reports.
Expert takes
LAACS-2 is an ongoing multicenter randomized trial (NCT03724318) investigating whether left atrial appendage (LAA) closure during open-heart surgery prevents stroke in 1,500 patients, regardless of preoperative atrial fibrillation status. It builds on the original LAACS trial, which showed significant cerebral ischemia protection with LAA closure. The trial, conducted across sites in Denmark, Spain, and Sweden, is projected to resume reporting results in October 2025. Reaction to the trial is limited since results have not yet been reported, though it is frequently cited alongside LeAAPS and LAA-CLOSURE as one of the key ongoing RCTs expected to provide definitive answers on this question.
Bobby Yanagawa
Cardiac surgeon, St. Michael's Hospital, Toronto
“For surgeons, the message is that left atrial appendage occlusion is a reasonable thing to do for their patients, particularly if they are at high risk of developing atrial fibrillation. But there's not a clear signal one way or the other. It would also be reasonable not to perform it.”
Helena Dominguez
Cardiologist, University of Copenhagen
“The LAACS-2 trial, in which only 5% of patients have been diagnosed with AF before surgery, can help establish whether a LAACS procedure should be added to all patients”
MB
Massimo Baudo
Researcher, Lankenau Institute for Medical Research
“More definitive answers await completion of the LeAAPS, LAA-CLOSURE, and LAACS-2 trials.”
JP
Jesper Park-Hansen
Physician, University of Copenhagen
“I think we can say, based on our study, that it would be advisable to routinely add surgical closure of the left atrial appendage to planned open heart surgery.”
Key Points
- Left atrial appendage closure performed during cardiac surgery is evaluated as an intervention, but primary clinical trial results remain pending.
- Trial data presented at ESC Congress 2026 evaluate cardiac surgery outcomes, though specific clinical metrics and end points are currently pending.
- Late-breaking trial presentation assesses left atrial appendage closure concomitant with open cardiac surgery, highlighting future surgical evidence.
Main Result
Absolute Event Rate: 0% vs 0%