LAAO

Left Atrial Appendage Occluder (LAAO): A One-Time Implant that Helps Reduce AFib Stroke Risk

Kootenai Health has performed nearly 500 LAAO procedures.

Left atrial appendage closure devices are implanted to reduce the risk of stroke in patients with nonvalvular atrial fibrillation (NVAF).

Who is a candidate?

Patients must have an increased risk for stroke with an appropriate reason to seek an alternative to blood thinners. LAAO is a one-time, minimally invasive procedure for people with atrial fibrillation not caused by a heart valve problem (also known as non-valvular AFib) who need an alternative to blood thinners. The LAAO devices are about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.

Left Atrial Appendage (LAAO) implants may be right for people who:

Have atrial fibrillation not caused by a heart valve problem (also known as non-valvular AFib)
Have been recommended for blood-thinning medicines by their doctor
Can take short term blood thinners but need an alternative

People may need an alternative to warfarin for any one of these reasons:

Have had major bleeding while taking blood thinners
Have a lifestyle, occupation, or condition that puts them at risk for major bleeding
Have difficulties taking their blood thinner as prescribed (staying in INR range, following dietary restrictions, missing doses, or inability to afford the prescription)

The Process

Patients who may qualify for an LAAO implant are first scheduled for a special consultation with one of our cardiologists to discuss specific risks and benefits. The cardiologist will also go over the details of the procedure. Following the initial consultation, patients meet with an implanter – our team of specialists will work with all your physicians to ensure we have the safest treatment plan before scheduling the procedure.

The Procedure

The LAAO device is implanted into your heart in a minimally invasive, one-time procedure. Your doctor makes a small cut in your upper leg and inserts a narrow tube, as done in a standard stent procedure. Your doctor then guides the LAAO device into your heart’s left atrial appendage. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

Learn more about how one LAAO device, the Watchman, works

Following the Procedure

Following the procedure, your doctor will prescribe you blood-thinning medication for 45 days or until your left atrial appendage is permanently closed off. During this time, heart tissue will grow over the implant to form a barrier against blood clots. Your doctor will monitor this process by taking pictures of your heart to see when you can stop taking your blood thinners.

Your doctor will then prescribe a medicine called clopidogrel (also known as Plavix^®) and aspirin for you to take for six months. After that, you’ll continue to take aspirin on an ongoing basis. A very small number of patients may need to keep taking blood thinners long term.