What is Left Atrial Appendage Occlusion?

Left Atrial Appendage Occlusion or LAA closure is a surgical procedure that obstructs the entrance of the left atrial appendage (LAA), a tiny sac within the muscle wall of the left atrium, to prevent the seepage of blood clots into the bloodstream. LAA closure, therefore, reduces the risk of stroke in patients with atrial fibrillation without the need for blood thinners.

Why is left atrial appendage closure required?

With atrial fibrillation, electrical impulses that regulate the heartbeat appear inconsistent. As a result, due to irregular and fast electrical impulses, the atria cannot contract in time and squeeze blood into the ventricles. The left atrial appendage is a tiny pouch, so blood can easily collect in the sac, causing blood clots to develop in the left atrial appendage and atria.

What forms of closure devices are used?

  • WaveCrest, Amulet and WATCHMAN are closure devices that obstruct the left atrial appendage entrance so blood clots cannot leave the LAA and travel through the bloodstream.
  • Closure devices that seal the stem of the left atrial appendage by clamping it at the base.
  • Sierra and Lariat are types of closure devices that use a suture loop or band to seal the LAA.

How do you perform left atrial appendage closure?

Minimally invasive surgery entails using a catheter to guide the closure device through to seal or obstruct the left atrial appendage. A closure device can function as a plug in the opening of the left atrial appendage, or the device can seal the LAA completely by means of clamping the LAA shut.

Dr Muller begins by inserting a catheter with the closure device in a vein in the groin area. Afterwards, he advances the catheter equipped with the device to the right atrium, creating an opening between the right and left atrium. Next, Dr Muller guides the catheter through the opening to the left atrial appendage. Then, the device is carefully placed in the left atrial appendage to seal the entrance so no blood clots can pass through. Once the procedure is complete, Dr Muller gently removes the catheter.


What imaging tests does Dr Muller utilise when performing left atrial appendage closure?

Dr Muller can decide to conduct any of the following tests to help guide him throughout the procedure:

  • Fluoroscopy
  • Transesophageal Echocardiogram (TEE)
  • Intracardiac ultrasound

What can I expect after the procedure?

After surgery, you are allowed to stay overnight in the hospital. Dr Muller conducts a transesophageal echo (TEE) within 48 hours after LAA closure.

What are the benefits of LAA closure?

Left atrial appendage closure aims to minimise the patient’s risk of stroke. Furthermore, additional benefits include the following:

  • Eliminate the patient’s reliance on blood thinning medications
  • Less invasive procedure, which means fewer risks of complications and a quicker recovery.

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