Valvular & structural heart diseaseRandomised controlled trial
Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial
- Randomised controlled trial
- multicentre
- open-label
- superiority
- 3 cardiac surgery centres in China
Authors' conclusion
For valvular surgery patients with CHA₂DS₂-VASc scores ≥2 but no pre-operative AF, routine prophylactic left atrial appendage closure did not significantly reduce the incidence of the primary composite endpoint (ischaemic stroke, TIA, and cardiovascular mortality) at 1-year follow-up.
Study context
- Population
- Non-AF patients with CHA₂DS₂-VASc ≥2 undergoing mitral or aortic valve repair or replacement2,118 in ITT population
- Participants
- 2,157 patients
- Comparison
- Prophylactic surgical LAAO vs no LAAO during valve surgery
- Surgical left atrial appendage occlusion (SLAAO)n = 1,062
- Controln = 1,056reference
- Primary endpoint
- Composite of:
- Ischaemic stroke
- Transient ischaemic attack (TIA)
- CV mortality
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
0.83
95% CI 0.61–1.14
P = 0.25
Events by treatment group
SLAAO vs Control
HR 0.83 (95% CI 0.61–1.14); P = 0.25
Original publication
Surgical left atrial appendage occlusion in valvular heart disease without atrial fibrillation: the OPINION trial. Eur Heart J. Published 1 September 2025. doi:10.1093/eurheartj/ehaf674
Summarised from the published abstract; every number is checked against it