Surgical management of the left atrial appendage: a must or a myth?

Surgical treatment of the left atrial appendage (LAA) has increased over the past few years. The most serious complication of atrial fibrillation is a cerebral cardioembolic stroke. In most patients with atrial fibrillation, the LAA is the anatomical source of the embolism. Several surgical techniques for occluding the LAA using different devices have been developed with different prospects of success. It is still not clear which of these techniques represents the optimum treatment for reducing the incidence of stroke in patients with atrial fibrillation. This text focuses on the surgical closure of LAA and critically considers the results with respect to closure success and the associated complications.