Objectives: Left atrial appendage ligation (LAAL) may constitute
alternative stroke prophylaxis in patients with atrial fibrillation (AF).
Herein we describe the 30-day post discharge outcomes of cardiac surgery patients with elevated
stroke risk with or without anticoagulation (AC) following epicardial LAAL. Methods: Data were reviewed for 479 consecutive adult patients who underwent
epicardial LAAL from 2014-2019 (median CHA2DS2-VASc score
= 4.0). There were 251 and 228 patients
discharged with and without AC, respectively, who were followed for 30
days. Patients were matched via 1:1 Propensity Score Matching (PSM; n = 115 per
group). Post-discharge outcomes included
stroke, bleeding, readmission for cardiac re-intervention, mortality,
and a composite endpoint comprised of the aforementioned outcomes. Results: There
was no difference in post-discharge stroke incidence regardless of AC (adjusted
cumulative incidence (ACI) 0.009 CI [0.001-0.043] with AC vs 0.009 CI [0.001-0.43] without AC; p = 0.826), post-discharge bleeding (ACI 0.018 CI [0.003
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