Interventional cardiology
Left Atrial Appendage Closure
Catheter closure of the left atrial appendage to reduce embolic risk in selected patients with atrial fibrillation.
Overview
Most clots associated with non-valvular atrial fibrillation form in the left atrial appendage. Closing this structure may offer an alternative when long-term anticoagulation is unsuitable.
Who may be considered?
It may be considered for patients with elevated stroke risk and major bleeding, high bleeding risk or another strong reason that limits long-term anticoagulant use.
How is the procedure performed?
A closure device is delivered from a femoral vein across the atrial septum and placed at the appendage opening under echocardiographic and X-ray guidance.
Recovery and follow-up
Follow-up imaging checks device position and sealing. Temporary anticoagulant or antiplatelet therapy is selected according to bleeding and clotting risk.
Risks and safety
Bleeding, pericardial effusion, stroke, device embolisation, device-related clot and incomplete sealing are recognised complications.