Left Atrial Appendage Closure (LAA Closure)

Left Atrial Appendage Closure (LAA Closure)

The left atrial appendage is a small pouch in the upper left chamber of your heart. In people with atrial fibrillation (AF)—a common heart rhythm disorder—blood can collect in this pouch and form clots. These clots can travel to the brain and cause a stroke.

If you have AF and are at high risk of stroke but cannot take long-term blood thinners due to bleeding concerns, an LAA closure may be a suitable alternative. This procedure seals off the pouch to help prevent clots from entering the bloodstream.

What happens after the procedure?

After the procedure, you will be monitored overnight in recovery or the Cardiac Care Unit (CCU). Your cardiologists will advise you about medications prior to the procedure. You may need to take blood-thinning medication for a short time while the device settles into place.

You should avoid heavy lifting or strenuous activity for a few days. Most people return to normal activities within a week.

A follow-up echocardiogram will be scheduled about 4–6 weeks after the procedure to check the position of the implant.

Please arrange for a family member or friend to take you home and stay with you overnight. You should not drive or make important decisions for 24 hours after having a general anaesthetic.

How is the procedure done?

  • You will be given a general anaesthetic, so you will be asleep and comfortable during the procedure.
  • A catheter (a thin, flexible tube) will be inserted through a vein in your groin and guided to your heart.
  • An ultrasound probe will be placed in your oesophagus (transoesophageal echocardiogram or TOE) to help your doctor see the heart clearly.
  • A small device called an occluder will be delivered through the catheter and positioned to seal off the LAA.
  • Once the device is in place, the catheter is removed, and the entry site is closed.

This is a one-time implant, and the device does not need to be replaced.

What are the risks?

  • Minor bruising or bleeding at the catheter site
  • Temporary abnormal heart rhythms
  • Sore throat from the breathing tube or ultrasound probe
  • Swelling or haematoma at the groin or arm

Less common risks

  • Stroke or mini stroke (TIA)
  • Blood clots (embolism), which may require blood thinners.
  • Accidental puncture of the heart, which may need surgery.
  • Infection at the implant site
  • Dislodgement of the device, requiring surgical correction
  • Fluid buildup around the heart

Rare risks?

  • Persistent abnormal heart rhythm requiring electrical correction.
  • Kidney damage from contrast dye
  • Difficulty accessing the vein—may require switching to another site.
  • Heart attack
  • Allergic reaction to contrast dye.
  • Radiation-related skin irritation
  • Air embolism
  • Nerve damage in the leg
  • Emergency heart surgery due to complications
  • Injury to the oesophagus from the imaging probe
  • Death, although this is extremely rare.

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