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Left Atrial Appendage Occlusion

The left atrial appendage (LAA) is a small, ear-shaped sac in the muscle wall of the left atrium (top left chamber of the heart). It is unclear what function, if any, the LAA performs.

In normal hearts, the heart contracts with each heartbeat, and the blood in the left atrium and LAA is squeezed out of the left atrium into the left ventricle (bottom left chamber of the heart).

When a patient has atrial fibrillation (irregular heart beat) the atria cannot effectively squeeze blood into the ventricles. Because the LAA is a little pouch, blood collects there and can form clots in the LAA and atria. When blood clots are pumped out of the heart, they can cause a stroke. People with atrial fibrillation are 5 to 7 times more likely to have a stroke than the general population. Studies have shown that, among patients who do not have valve disease, the majority of blood clots that occur in the left atrium start in the LAA.

Taking a blood thinner, such as warfarin, reduces the risk of stroke in patients with atrial fibrillation. Many patients have concerns about taking warfarin or have side-effects or poor control. New medications are available but some patients cannot tolerate these medciations either.

If you are at risk of developing clots in the left atrium/LAA a procedure to seal off your LAA can . reduce your risk of stroke and eliminate the need to take blood-thinning medication. The procedure is carried out under genral anaesthesia and echo and x-ray guidance. It is generally very safe and effective. At LHCH we have an established programme for LAA closure. Referral would usually come via your local cardiologist.