Left Atrial Appendage Closure (LAAC)
is a normal part of the heart anatomy and causes no problems in the majority of people.
However, this pouch can be a major source of blood clots in patients with an irregular heart beat known as atrial fibrillation.
Atrial fibrillation (AF) is a risk factor for blood clots blocking blood flow to the brain and causing a stroke. Stroke can cause temporary or permanent brain or organ damage and is one of the top healthcare costs in many countries.
The prevalence of AF increases with age and approximatey 4% of persons >60 years have this condition.
More than 90% of blood clots are located in the left atrial appendage in patients with nonrheumatic, nonvalvular AF. Current evidence suggests that catheter-based closure of the left atrial appendage can be effective in reducing the risk of blood clot-related complications associated with nonvalvular AF.
“I had a left atrial appendage occlusion in the Bon Secours Hospital, Cork in November 2018. My GP referred me after complications with my health. Dr Cróchán O’Sullivan explained the procedure in full and answered all my questions. The procedure was a great success. I am extremely grateful to my GP (Dr Eamonn O’Grady) and all the staff at the Bons, but especially to Dr Cróchán O’Sullivan for his exceptional care and super performance.”
How is the left atrial appendage related to stroke in patients with atrial fibrillation?
During AF, blood clots have the potential to form in the LAA. When the heart rhythm normalizes, those blood clots can flow out of the LAA into the left atrium and enter the oxygen-rich blood stream. As mentioned above, oxygen-rich blood flows from the left atrium to the left ventricle and is then pumped out to the body. If blood clots are pumped out to the body, they may block flow of oxygen-rich blood to the brain and ultimately cause a stroke.
What Treatment Options Are Available To Reduce The Risk Of Stroke In Patients With Atrial Fibrillation?
There are a number of treatment options to reduce the risk of stroke in patients with atrial fibrillation, and there is no single option that is right for every patient. You should discuss with your doctor to learn about the best treatment option for you; however, there are a few standard approaches of which you should be aware. The first option is medication (i.e. blood thinners) which may be appropriate. Other treatment options include open-heart surgery to remove or close the LAA and catheter-based procedures to close the LAA.
How Do I Know Which Treatment Option Is Right For Me?
Every person is unique. Your doctor is your best resource for learning about the treatment options available to you and the best course for your condition. Talk to your doctor and follow his or her advice for your care.
What is involved with a catheter-based procedure? A catheter-based procedure is a minimally invasive treatment option which involves inserting a small tube, called a catheter, through an incision typically in the groin. The catheter is navigated through the blood vessels to the procedure site within the heart. In a catheter-based LAA closure procedure, the doctor guides the closure device through the catheter to seal the entrance of the LAA. Once the device is placed in the LAA, the doctor will carefully study its position using cardiac imaging systems. Once satisfied with the position, the device is released to remain permanently in the LAA. The catheter is removed and the procedure is completed.
The procedure itself should last about one to two hours and will take place in a heart catheterization laboratory. Your doctor may give you an anesthetic, and you should not feel any significant discomfort.
What Exactly Is An Amplatzer™ Amulet™ Left Atrial Appendage Occluder?
An AMPLATZER left atrial appendage occluder is a device specifically designed to non-surgically close the LAA. The device is placed in the LAA during a catheter-based procedure and will remain permanently implanted.
All AMPLATZER left atrial appendage occluders are made from braided nitinol wires. Nitinol is a metal with shape memory characteristics, meaning the device will return to its original ‘memorized’ shape even after it is stretched to pass through a catheter. The shape of the device was specifically designed to close the opening of the LAA.