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Page 8 of 21 Dokko et al. Vessel Plus 2022;6:37 https://dx.doi.org/10.20517/2574-1209.2021.121

3 M/C 2 M/C 1 M/C
[77]
Ad et al. 2018 1 C 2 C
[91]
Keßler et al. 2018 1 M
Spieker et al. [159] 2018 1 M 3 M
[160]
Kim et al. 2018 2 M/C
Kitamura et al. [161] 2019 2 M 1 M
[162]
Ailawadi et al. 2019 1 M 4 M 1 M
[2]
Grigioni et al. 2019 1 M 2 M 1 M 1 M
[96]
Wu et al. 2020 1 C 1 C 1 C
Cardiovascular disease or devices included left ventricular ejection fraction, post-operative mitral regurgitation, echocardiographic score, post-operative mitral valve area, post-operative mean pulmonary artery
pressure, New York Heart Association functional class, right ventricular pressure, left atrial dimension, left ventricular fractional shortening, cardiomegaly, heart failure, left ventricular diastolic diameter, valvular
heart disease, cardiomyopathy, cardiovascular disease, myocardial infarction, European System for Cardiac Operation Risk Evaluation, mitral regurgitation etiology, right ventricular systolic dysfunction, peripheral
artery disease, tricuspid regurgitation, mitral regurgitation, N-terminal pro b-type natriuretic peptide, tricuspid annular plane systolic excursion, stroke, mitral valve pressure gradient, previous coronary artery bypass
graft, and previous aortic valve intervention. Other non-cardiovascular comorbidities included chronic obstructive pulmonary disease, lung disease, renal failure, renal dysfunction, dialysis, serum creatinine, anemia,
and diabetes. Procedural characteristics included the need for coronary artery bypass graft at the time of surgery, tricuspid valve repair, omission of the Cox maze procedure, failure to use box lesion, procedural
success or failure, surgeon experience, cryothermal energy source, heart failure hospitalization, transfusion of blood, length of hospital stay, and type of surgery performed. Socioeconomic/demographic factors
included age and gender.

compared to LAA preservation . A retrospective study compared pre-operative atrial fibrillation patients undergoing MV surgery with or without LAA
[81]
exclusion and/or ablation . Among patients who did not receive ablation, preservation of the LAA was associated with higher risks of thromboembolism and
[82]
death. There was no significant impact of LAA exclusion versus preservation in patients who received concomitant ablation . Similarly, one study of pre-
[82]
operative atrial fibrillation patients undergoing MV surgery with concomitant radiofrequency ablation did not find a significant impact of LAA exclusion on 2-
year freedom from atrial fibrillation . In contrast, another study found LAA occlusion was only associated with decreased rate of cerebrovascular events
[83]
following MV surgery in pre-operative atrial fibrillation patients when concomitant surgical ablation was performed .
[84]
The impact of LAA obliteration during MV procedures to address atrial fibrillation is not clear. Additionally, surgical ablation may modulate the effect of LAA
obliteration. Randomized control trials are needed to evaluate the effectiveness of LAA exclusion with or without ablation in reducing risk of
thromboembolism for pre-operative atrial fibrillation patients.

Transcatheter mitral valve repair
Similar to its impact on MV surgery, pre-operative atrial fibrillation has also been associated with adverse long-term outcomes in patients undergoing
transcatheter MV repair via MitraClip but with conflicting results on short-term outcomes such as in-hospital mortality, in-hospital complications and
resource utilization [85-90] . One study reported greater in-hospital ischemic stroke, in-hospital hemorrhagic stroke, length of hospitalization, and increased 30-