Left Atrial Appendage Closure

The human heart has an out-pouching in the left atrium known as the Left Atrial Appendage. In the case of patients with atrial fibrillation or Afib, blood pooling in the LAA increases stroke risk, and becomes a significant problem. This pooling blood then thickens and clots. If any part of that clot breaks away, it can travel to the brain and cause a stroke. Indeed, Afib patients are at a five-times-higher risk of stroke than those that do not have Afib. Many patients will benefit from anticoagulant medication, which lowers the likelihood of a blood clot forming in the LAA. However, as we discussed in treatments for Afib, medication proves ineffective or has unacceptable side effects in about 50% of patients.

For patients with a significant risk for stroke, or those for whom medication has not offered expected results, left atrial appendage closure/occlusion may be a good option. Typically, left atrial appendage closure is performed using a minimally invasive procedure. We offer 2 such procedures known as the Lariat and the implantation device. 

The Lariat seals off the left atrial appendage using sutures to close the opening. Suturing the left atrial appendage closed allows any clotted blood to remain in the LAA with a much-reduced risk of stroke.

Alternatively, the implanted device is a small parachute-like device that fits snugly over the opening to the left atrial appendage. Using advanced catheter technology, it is threaded to the heart through a blood vessel. Once placed, the device is deployed and effectively seals the LAA including all the pooling blood within. In time, scar tissue forms around the device which acts as a lattice for a complete seal. Proper placement can significantly reduce the risk of stroke in Afib patients. 

Closure of the left atrial appendage can be performed alongside a cardiac catheter ablation in certain patients who qualify.