Why you might need?
In Atrial Fibrillation (AF) the blood flow through the heart slows down, and the risk of a stroke rises.
Warfarin therapy is the most common way of reducing the risk of stroke; a type of medicine that reduces the risk of clots by thinning the blood. Alternatives are the Direct Oral Anticoagulants (DOACs) such as Apixaban, Edoxaban, Dabigatran, and Rivaroxiban.
If anti-coagulation cannot be taken, the LAA closure can be done to reduce stroke risk. To assess for this, your stroke risk and bleeding risk are assessed and you may have a Transoesophageal Echocardiogram (TOE) and CT scan.
When blood flows through the heart slowly, as it does in Atrial Fibrillation (AF), it tends to form clots. These mainly form in and out pouching of the heart called the Left Atrial Appendage (LAA).
Closing the LAA has been shown to reduce the risk of stroke.
What happens with a Left Atrial Appendage Closure?
Before your procedure you will be given a general anaesthetic. To help your consultant navigate, your operation will be guided by X-rays and ultrasound pictures from a probe in your throat (TOE).
A pipe will be passed through a catheter which will be placed from your groin up to your heart and a wire passed across your heart and into the mouth of the appendage.
A stiff tube will be passed over the wire and a plug-like device is place into the mouth of the appendage. Once the Cardiologist is happy that the device is well placed, it will be released and all other equipment removed.
If you are not suitable for device based closure, a surgical procedure to close the LAA may be suitable for you.
Although a fairly safe procedure, a risk of 3-5% is usually quoted. The main complications with LAA closure include:
- Groin issues- bleed, bruise, pain
- Internal bleeding
- Incomplete closure of the left atrial appendage
- Dislodgement of the device
- Blood clotting forming on the device, leading to stroke