Stroke-Prevention Device
Left Atrial Appendage Closure
Left atrial appendage closure is a device-based procedure to reduce stroke risk in selected patients with atrial fibrillation who cannot take long-term blood thinners. It is not an ablation procedure.
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Understanding the Procedure
What Is LAA Closure?
The left atrial appendage (LAA) is a small pouch on the wall of the left atrium. In atrial fibrillation, blood can pool in it, and clots that form there may travel to the brain and cause a stroke.
In LAA closure, a device is placed at the opening of the appendage through a catheter, aiming to seal it off. The goal is to reduce stroke risk without relying on long-term anticoagulants.
LAA closure is a stroke-prevention strategy. It does not treat the arrhythmia itself, and it is not an ablation.
Patient Selection
Who May Be Considered?
Atrial fibrillation with stroke risk
Patients whose stroke risk would normally call for anticoagulation.
Reasons to avoid long-term anticoagulants
Such as previous significant bleeding, bleeding-prone conditions or intolerance, where the decision is individual.
A decision made by a team
Medication remains the standard approach for most patients, and closure is considered when it is judged suitable.
Short-term blood thinners or antiplatelet therapy are often needed after the procedure. Your doctor will explain the plan.
Preparation
Assessing Suitability
Risk review
Stroke and bleeding risk are assessed together with your history.
Imaging
Transoesophageal echocardiography or cardiac CT checks the size and shape of the appendage and excludes clot.
Device selection
The device is chosen to match the anatomy.
Fasting, medicines and anaesthesia are arranged in advance.
The Procedure
How the Device Is Placed
Access
A catheter is introduced through a vein at the groin, under anaesthesia or sedation.
Cross
The catheter is passed to the left atrium through the atrial septum.
Position
The appendage is imaged and the device is positioned at its opening.
Release
Position and seal are checked before release.
Recovery
Observation, then discharge as advised by your team.
After the Procedure
Follow-Up, Benefits and Risks
The device becomes covered with tissue over time. Follow-up imaging checks that the appendage is sealed and that no clot has formed on the device, and medicine plans may be adjusted accordingly.
Closure may lower stroke risk in appropriately selected patients, but it does not eliminate it.
Risks include bleeding or pericardial fluid, vascular access complications, device-related clot and, rarely, device displacement.
Your physician will explain the balance of risks and benefits in your case.
Atrial fibrillation itself may still need treatment with medication or ablation.
Questions
Frequently Asked Questions
Is LAA closure the same as ablation?
Will I stop blood thinners completely?
Is it open-heart surgery?
Can it be combined with AF ablation?
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