Stroke Clinical Trial
Official title:
Phase III Pilot Study - Left Atrial Appendage Occlusion Study
A pilot, multicentre randomized controlled study of surgical left atrial occlusion (LAA) in
50 patients with atrial fibrillation/flutter undergoing cardiac surgery requiring
cardiopulmonary bypass with additional risk factors for late stroke.
Patients will be enrolled and randomized to undergo LAA exclusion and aspirin therapy or
best medical therapy as per guidelines.
Main research questions:
1. Can successful occlusion of the LAA be safely achieved by cut and sew or stapler
techniques?
2. In patients with atrial fibrillation with 2 or more risk factors for stroke, will
removal of the left atrial appendage (LAA) and aspirin therapy reduce the risk of
systemic embolic events and major bleeding compared to warfarin?
The number one cause of disability and the 3rd leading cause of death in patients with
atrial fibrillation (AF) is stroke. Echocardiographic studies suggest that the predominant
source of stroke in AF is the left atrial appendage (LAA). At present, there are no
sufficiently powered trials to answer whether removal of the LAA can reduce the risk of
systemic embolic events.
LAAOS pilot study will recruit 50 participants undergoing open-heart surgery in 5 Canadian
academic cardiac surgery centers. The study will inform the feasibility of conducting a
large RCT and will provide information of the efficacy and safety of appendage occlusion
technique. From this study we envision a a large international randomized controlled trial
(LAAOS II) to determine the impact of left atrial appendage occlusion on the composite
outcome of stroke and non-central nervous system systemic embolic events in at risk patients
with atrial fibrillation undergoing cardiac surgery.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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