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Left Atrial Appendage Closure (LAA)

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A bisection model of a heart illustrates Left Atrial Appendage Closure (LAA).
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Left Atrial Appendage (LAA) Closure - An Overview

The Left Atrial Appendage is a small pouch, shaped like a windsock, found in the top left of your heart( the Left Atrium). Like your appendix, your Left Atrial Appendage doesn’t really have a clear role to play in your body.

In Atrial Fibrillation, the heart beats very rapidly, causing blood clots that can lead to strokes. In such life-threatening situations, Dr. Karthigesan may suggest the Left Atrial Appendage Closure or Left Atrial Appendage Occluder(LAAO) to minimise the risk of stroke.

This minimally invasive procedure closes the opening to the left atrial appendage to prevent blood clots that break off from here from swimming into your bloodstream. If you have suffered an A-Fib and are at an increased risk of a stroke, Dr. Karthigesan may put you on blood thinners as a precautionary measure. Unfortunately, however, if you are at risk of falling or bleeding out, he may recommend the LAA closure, which is a better option than blood thinners.

The primary objective of this procedure is to close your left atrial appendage, a small sac attached to the left atrium wall and reduce the risk of a stroke.

With his wide-ranging experience in Cardiology, Dr. Karthigesan has successfully treated innumerable patients with various cardiac complications. He is a one-of-a-kind doctor who believes in and practices compassionate, empathetic care coupled with the latest cardiac treatments. His expertise includes interventional cardiology, device therapy and various other life-saving treatments for your heart.

Image showing an ongoing Left Atrial Appendage (LAA) Closure procedure.
Image showing the insertion of a Cardiac Plug.Decorative red spiral.Decorative blue spiral.

Types of LAAO Procedures

Cardiac Plug
This umbrella-like device is inserted into the heart using a catheter. When the catheter is positioned at the LAA opening, the occluding device is implanted into the LAA to stop blood flow into the appendage.
Surgical Clamping
If Dr. Karthigesan feels that your LAA should be clamped shut to prevent a stroke, he will recommend open-heart surgery. This invasive procedure is often clubbed with other major surgeries like a valve or coronary bypass surgery.
A medical professional monitoring the Transesophageal Echocardiogram.

Left Atrial Appendage (LAA) Closure: Evaluative Tests

  • To prepare you for your LAA closure, Dr. Karthigesan will recommend a TEE or Transesophageal Echocardiogram.
  • This test will allow him to assess the LAA dimensions. This information is vital because the left atrial appendage dimensions vary for everyone.
  • TEE images to ensure your heart is free of life-threatening clots.

Left Atrial Appendage Closure: The Procedure

  • Different techniques are used to close or seal off the LAA of the heart, a rudimentary appendage with no function or purpose. However, for those with A-Fib, the LAA is the main location for blood clot risks because of the low blood flow to the sac.
  • LAA closure is the catheter-based keyhole procedure done from the groin under sedation or general anaesthesia.
  • A blot clot moving out of the LAA is sent to the left ventricle, which is the heart’s primary pumping chamber. If left untreated, this blood clot can travel to the brain and cause potentially profound implications.
  • By closing off the LA appendage, the risk of blood clots is considerably reduced. The LAA closure also does not hamper the normal functioning of the heart.
The image illustrates the Left Atrial Appendage Closure procedure.

LAA Closure: Before, During & Post-Procedural Care

  • You will undergo a TEE or Transesophageal Echocardiogram or a Cardiac CT to understand the dimensions of your left atrial appendage.
  • Dr. Karthigesan may also recommend a 3D printing of the TEE to decide on the device and its size.
  • You should discuss with your doctor your diabetic and blood thinning medication if you are taking any.
  • The procedure will be done either under IV sedation or general anesthesia.
  • A device-loaded catheter is inserted into your vein near your groin region.
  • The catheter is moved to your right atrium and then into left atrium towards Left Atrial Appendage (LAA).
  • The catheter is threaded through the hole until it reaches your LAA. The doctor will then insert the device into it to seal off the opening and prevent any blood clots from escaping.
  • The catheter is then removed and the device stays in. Over time a thin layer of tissue will grow over the surface of the device.
  • You will be moved to the Cardiac Ward for further monitoring and post-procedural observation.
  • Depending on your progress, Dr. Karthigesan will decide your hospital stay duration. He will also decide if you need any blood thinners.
  • He will recommend further TEE tests to make sure the closure remains sealed.
  • Before you are discharged, you will be advised on recovering well and taking care of your health, which you must follow sincerely.
  • You must immediately consult your doctor should you experience any concerning signs and symptoms.

LA Appendage Closure: The Benefits

  • Prevents the need for lifelong oral anticoagulation medication intake for stroke prevention and the intake of blood thinners.
  • Reduces the risk of stroke
  • The procedure can be done during another major heart surgery for other cardiac issues.
  • You can also have a minimally invasive procedure for a left atrial appendage closure device.
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Put a Stop to

Deadly Blood Clots

Trust Dr. Karthigesan’s expertise with LAA closure procedures. Schedule a quick consultation today.

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LAA Closure: More Details Explained

The LAA closure is a catheter-based keyhole procedure done under IV sedation or general anaesthesia. Dr. Karthigesan will start the procedure from the groin area. The closure device is taken into the left atrium and positioned in LAA under transesophageal or intracardiac ECHO and fluoroscopy guidance.

Dr. Karthigesan will recommend a Left Atrial Appendage Closure Procedure for the following conditions:

  • If you have Atrial Fibrillation where the heart is unable to squeeze blood out of your left atrium, therefore collecting in your left atrial appendage and increasing the risk of a stroke.
  • If you are unable to take powerful blood thinner medications ( anticoagulants) or have a contraindication to prescribed blood thinner medications.

Yes. Millions of people all across the world have undergone LAA closures to prevent stroke in Atrial Fibrillation.

The LAA closure procedure is a relatively safe procedure. However, there are certain rare situations where unexpected complications may arise. They are:

  • Abnormal heart rhythms
  • Pericardial effusion
  • Unexpected infections
  • Cardiac arrest
  • Pain in the chest
  • Reactions to anaesthesia
  • Unexpected bleeding
  • Device malfunction

Although we are yet to find a guaranteed way for stroke prevention, LAA appendage closure significantly reduces your stroke risks because most strokes that begin from the atrium commence from the LAA. According to device studies, people with left atrial appendage closure devices also have a lower stroke risk.

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