{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:19:06Z","timestamp":1779124746538,"version":"3.51.4"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Atrial Septal Defect\/Patent Foramen Ovale (ASD\/PFO) occlusion is performed to prevent paradoxical embolism and reduce the risk of recurrent ischemic stroke. Left atrial appendage (LAA) closure is used as an alternative to medical therapy of non-valvular atrial fibrillation for prevention of stroke. Multiple studies have examined performing LAA and ASD\/PFO occlusion. However, the feasibility and safety of combined occlusion of the left atrial appendage and ASD\/PFO are not clear, furthermore, these studies are limited by their small sample sizes and retrospective analysis. In this study, we aimed to systematically review and meta-analyze the feasibility and safety of combining left atrial appendage and ASD\/PFO closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Web of Science, CNKI, Cochrane Library, Embase, and WanFang database were searched up to April 2022 to identify peer-reviewed human studies on assessing the feasibility, safety, and efficacy of combining left atrial appendage and ASD\/PFO closure. The primary outcome was calculated: procedural feasibility outcome and procedural safety outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 articles, including 340 patients from multiple countries, were included in the analysis. The principal findings of our study are: compared with single LAA closure, (i) combining PFO\/ASD occlusion and LAA closure had similar procedural success proportion (98.43%, 95% CI: 96.67\u2013100.00%), (ii) similar safety event incidences developed (1.67%, 95% CI: 0.24\u20133.92%), subgroup analyzed safety event incidences in death was 0.00 (95% CI: 0.00\u20130.33%), cardiac tamponade was 0.87% (95% CI: 0.00\u20132.77%), device embolization was 0.00 (95% CI: 0.00\u20130.60%), major bleeding was 0.00 (95% CI: 0.00\u20130.33%), stroke was 0.00 (95% CI: 0.00\u20130.02%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although this systematic review and meta-analysis demonstrate the technical feasibility and safety of combining closure of PFO\/ASD and LAA, further studies of sufficient sample size, long-term follow-up, and rigor endpoint criteria are yet needed to fully evaluate this combination procedure for its role in clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.1080257","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T23:20:05Z","timestamp":1673047205000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The feasibility and safety of combining atrial septal defect\/patent foramen ovale and left atrial appendage closure: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Yi","family":"Song","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter David","family":"Koch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007146","article-title":"Patent foramen Ovale closure for stroke prevention and other disorders.","volume":"7","author":"Collado","year":"2018","journal-title":"J Am Heart Assoc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1136\/heartjnl-2014-306552","article-title":"Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure.","volume":"101","author":"Nyboe","year":"2015","journal-title":"Heart."},{"key":"B3","first-page":"179","article-title":"Left atrial appendage closure for \u201cprimary primary\u201d prevention during percutaneous closure of septal defects in patients with large atria but no atrial fibrillation.","volume":"25","author":"Kuwata","year":"2018","journal-title":"Cardiol J."},{"key":"B4","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1016\/0003-4975(95)00887-X","article-title":"Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation.","volume":"61","author":"Blackshear","year":"1996","journal-title":"Ann Thorac Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2614","DOI":"10.1016\/j.jacc.2015.04.025","article-title":"Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis.","volume":"65","author":"Holmes","year":"2015","journal-title":"J Am Coll Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.5603\/KP.2016.0172","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS.","volume":"18","author":"Kirchhof","year":"2016","journal-title":"Eur J Cardiothorac Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3754","DOI":"10.1161\/STR.0000000000000046","article-title":"Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American heart association\/American stroke association.","volume":"45","author":"Meschia","year":"2014","journal-title":"Stroke."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2262","DOI":"10.1056\/NEJMoa071422","article-title":"Patent foramen Ovale and cryptogenic stroke in older patients.","volume":"357","author":"Handke","year":"2007","journal-title":"N Engl J Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1161\/01.STR.24.1.35","article-title":"Classification of subtype of acute ischemic stroke. 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