Left Atrial Appendage Closure

Percutaneous Left Atrial Appendage Closure (LAAC) is a minimally invasive procedure performed to reduce the risk of stroke in patients with atrial fibrillation (AF).

In atrial fibrillation, the heart beats irregularly, increasing the risk of blood clot formation.
In approximately 90% of cases, these clots form in a small pouch of the heart called the left atrial appendage (LAA).
If a clot breaks free and travels to the brain, it can cause a stroke.

This procedure seals the left atrial appendage, preventing clots from forming or escaping into the bloodstream. It is particularly recommended for patients who:

have a high risk of stroke
cannot take long-term blood thinners (anticoagulants) due to bleeding risk or intolerance

How the procedure is performed

The procedure takes place in a hospital, in a cardiac catheterization or hybrid lab, guided by transesophageal echocardiography and fluoroscopy.

General anesthesia or deep sedation is administered for comfort and precision
A catheter is inserted through the femoral vein (in the groin)
The catheter is advanced to the heart and crosses into the left atrium through a small controlled puncture in the interatrial septum (trans-septal puncture)
Once positioned at the left atrial appendage, a closure device (a plug-like implant) is released to seal it permanently
The device remains in place, preventing clots from leaving the appendage

Procedure duration: 45–90 minutes

The device is not felt by the patient and does not interfere with normal heart function.

After the procedure

Typical hospital stay is 1–2 days
Most patients resume normal activities within a few days
A short course of antiplatelet or anticoagulant therapy may be prescribed depending on the clinical case
Follow-up imaging (echocardiogram) is scheduled to confirm correct device positioning

Key benefits

-Significant reduction in stroke risk
-Effective alternative for patients who cannot take long-term anticoagulants
-No open-heart surgery, minimally invasive approach
-Fast recovery and short hospitalization
-Permanent implant with no impact on daily life

Who is a candidate for LAAC?

Patients with non-valvular atrial fibrillation who:

are at high risk of stroke
have contraindications or intolerance to long-term anticoagulation
are suitable for the procedure based on anatomical assessment (via transesophageal echo and/or cardiac CT)

The decision is made by a multidisciplinary Heart Team, including cardiologists, interventional cardiologists/electrophysiologists, imaging specialists, and anesthesiologists.