The vast majority of patients with non-valvular atrial fibrillation (AF) are managed with the administration of anticoagulation (blood-thinners) to reduce their risk of clot formation and stroke risk.
In some patients, these medications are associated with a risk of significant and potentially life-threatening bleeding. In these instances where this strategy is contraindicated, LAAO may be suitable to reduce the risk of future stroke.
- What is left atrial appendage occlusion (LAAO)?
Left atrial appendage occlusion (LAAO) is a minimally invasive percutaneous treatment aimed at closing off the left atrial appendage (a small pouch in the left atrium) with the aim of reducing the ability of clot formation and subsequent risk of stroke in patients with non-valvular atrial fibrillation (AF).
- Why do I need a LAAO?
- What are the risks?
The risk of LAAO is 1-2% and includes vascular injury, stroke, damage to the heart, failure, device embolisation and death.
- How do I prepare for the procedure?
Prior to your procedure, you will have undergone a number of investigations to determine suitability of LAAO including a transoesophageal echocardiogram (TOE), CT scanning and blood tests.
Once a date for your procedure has been organised you will be given specific information with regards to admission times and also your medications.
You should not eat or drink for 6 hours prior to your procedure.
Prior to your procedure, you shall also be reviewed by an anaesthetist. - What happens during the procedure?
Prof Ruparelia performs all procedures under a general anaesthetic with the aid of X-ray and TOE guidance.
A small tube is positioned in the vein at the top of your leg (femoral vein). A trans-septal puncture is performed and the left atrial appendage is sized. A device is then positioned in the appendage to close off the opening and therefore reduce the risk of clot formation within it.
The procedure takes approximately1 hour and you are usually woken up in the operating room straight after your procedure - Recovery and post-procedural care
You will be asked to lie flat in bed for a few hours to aid in the healing of the legs. You can eat and drink immediately after your procedure.
You should be able to sit out of bed within 2-4 hours and thereafter. If your procedure was performed in the morning you may be able to go home that evening or the following day.
When at home you are able to walk and gradually build up your exercise tolerance and activity.
Prof Ruparelia shall organise a follow up with clinical assessment, ECG and and echocardiogram following your procedure.
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