Left Atrial Appendage Occlusion
What is a Left Atrial Appendage Occlusion?
If you have atrial fibrillation and you are at increased risk for a stroke, your cardiologist may recommend blood thinners. If you’re unable to take a blood thinner, a left atrial appendage occlusion may be recommended. When your heart pumps in an irregular way, you may have decrease blood flow to the rest of your body, and this may cause a blood clot. Most blood clots form in the left atrial appendage (LAA). The LAA is small, ear-shaped sac in the muscle of the left atrium, which is the top left chamber of your heart. In normal hearts, the blood in the left atrium is squeezed out of the left atrium into the left ventricle, the bottom left chamber of your heart. When you have atrial fibrillation, blood can collect in the LAA and form blood clots. When the blood clots are pumped out of your heart, you can have a stroke.
There are several options and devices to close your LAA to prevent blood clots, reduce your risk of a stroke and eliminate the need to take blood-thinners. These options include:
The WATCHMAN™ is a parachute-shaped, self-expanding device that closes your LAA.
The LARIAT device is used to place a loop stitch around the base of the left atrial appendage to permanently seal it from the rest of your heart to block stroke-causing blood clots.
The AtriClip device is placed on the outside of the heart to seal off the LAA. It’s placed using minimally invasive procedure called a keyhole procedure using three small keyhole incisions of the left side of your chest.
Your Saint John’s Physician Partners cardiologist will discuss the benefits and risks of your LAA treatment options.
Why a Left Atrial Appendage Occlusion?
The main goal of a left atrial appendage occlusion is to prevent strokes. Your cardiologist may recommend a left atrial appendage occlusion, if you have concerns or cannot take blood thinners. With blood thinners you will have frequent blood draws, face an increased risk of bleeding or may not tolerate the medication. Whereas a left appendage occlusion has proven to be an effective option in reducing the risk of Afib-related stroke, especially if an oral anticoagulant is contraindicated.
Left Atrial Appendage Occlusion Potential Risks and Complications
An LAA device is a permanent solution, but as with all surgical procedures, you may have complications with the implantation procedure, such as infections or bleeding at the insert site. Your cardiologist will review the risks and benefits of the procedure so you can make an informed decision.
Preparing for a Left Atrial Appendage Occlusion
Your cardiologist will give you instructions on preparing for a left atrial appendage occlusion and what to expect.
What to Expect
What to Expect During a Left Atrial Appendage Occlusion
During a Left Atrial Appendage Occlusion
A left atrial appendage occlusion is generally performed under general anesthesia in the hospital catheterization lab. During the procedure, your cardiologist will:
- Insert a catheter into a vein near your groin and guide to the opening of the LAA, using X-ray and computed tomography (CT) scan.
- The device is then placed in the opening of the LAA to seal it and keep it from releasing blood clots.
- If you have the WATCHMAN™ device implanted, your cardiologist will place it into the LAA, where it opens up like an umbrella to permanently implant and seal it.
- The procedure generally takes an hour or more.
- You will then be taken to recovery to monitor your vital signs and will stay in the hospital overnight.
- Once the device is in place, a thin layer of tissue grows over it in about 45 days.
After a Left Atrial Appendage Occlusion
Recovery is generally quick and you should be able to return to normal activities within 24 to 48 hours. You’ll be advised to not do any heavy lifting for at least a week. You’ll need to continue taking an anticoagulant medication and a daily aspirin for 45 days after the procedure. After six months, you will probably only take aspirin. It’s important that you follow your cardiologist’s instructions. You’ll have an appointment with your cardiologist 45 days after the procedure. Be sure to let your cardiologist know if you’re experiencing any difficulties.