What is a Left Atrial Appendage (LAA)?
It is a small ear-like pouch in the wall of the left atrium of the heart. It forms during the fourth week of embryonic development. The function of the LAA is unknown.
What is Left Atrial Appendage (LAA) Closure?
LAA closure is a surgical procedure performed to seal off the left atrial appendage in the heart using a self-expanding device. It is usually performed as a catheter-based surgery.
When is Left Atrial Appendage Closure Necessary?
Left atrial appendage closure may be necessary for a person diagnosed with atrial fibrillation. This condition is characterized by a very rapid and irregular heartbeat that can cause a collection of blood in the left atrial appendage. This can increase the risk of clot formation in the left atrial appendage and the likelihood of a stroke.
Indications for Left Atrial Appendage Closure
Your surgeon may suggest left atrial appendage closure if:
- You are at higher risk of having a stroke
- You do not want to rely on medications and need an effective treatment
- You do not respond to blood-thinning medications
- You do not respond to cardioversion technique used to restore heart rhythm
Preparation for Left Atrial Appendage Closure
Inform your doctor about any allergies or medications that you are currently taking.
Do not eat or drink after midnight on the day prior to your procedure.
Prepare for an overnight stay at the hospital and arrange for someone to drive you home the next day.
Certain blood tests may be performed.
Left Atrial Appendage Closure Procedure
Prior to the procedure the catheter-insertion site is cleaned and shaved. An intravenous line is established to give medications and fluids. During the procedure, your breathing rate, heart rate, and blood pressure will be monitored. You may be given general anesthesia so you can sleep through the procedure.
- A small incision is made near your groin area.
- A catheter (small tube-like structure) is inserted through the vein and guided towards the heart.
- A left atrial appendage closing device is placed at the opening of the left atrial appendage.
- The device is self-expanding and causes closure of LAA.
- Your surgeon removes the catheter and closes the incision.
Recovery after Left Atrial Appendage Closure
- Do not work for a minimum of 3 days after the procedure.
- You need to walk 4-5 times a day the next day after the surgery.
- You can shower, but avoid getting water on the bandage.
- Regularly check for any infections at the site of incision for a few weeks after surgery.
- Your surgeon may suggest the continuation of blood-thinning medications for a few weeks.
- You must regularly follow up with your surgeon to check for proper closure of the LAA.
Risks Associated with Left Atrial Appendage Closure
Left atrial appendage closure is a very safe procedure, however, there is a minimal risk of complications that include infection, injury to the heart, allergic reaction, stroke, bleeding, or the closing device moving out of position.
Benefits of Left Atrial Appendage Closure
The benefits of left atrial appendage closure include:
- Reduced risk of blood clots developing within the left atrial appendage, which may enter the bloodstream and result in a stroke
- Can be helpful for patients who cannot use anticoagulant medication or wish to avoid doing so