Left Atrial Appendage Closure Devices

Condition

The left atrial appendage (LAA) has been identified as the main location of thrombus formation particularly in patients with non-valvular AF. In certain patients with Atrial Fibrillation, blood thinners cannot be prescribed due to a variety of reasons and therefore their risk of a stroke becomes even higher.

Treatment

In these cases occluding the LAA is a treatment option. The most studied devices we implant are the Amplatzer™ Cardiac Plug, the WATCHMAN™ device, and the LARIAT® Suture Delivery Device. Our institution is considering implanting newer devices currently under investigation, such as the Coherex® WaveCrest System.

Left Atrial Appendage (LAA) Anatomy

Bone Illustration

This represents classical chicken wing morphology. Note the relationship with the left atrium (LA), left superior pulmonary vein (LSPV) and left ventricle. 
*Heavy trabeculations (pectinate muscles).



WATCHMAN™ Device

Bone Illustration 2



LARIAT® Suture Delivery Device

Bone Illustration 3

The endocardial and epicardial magnet tipped guidewires in the LAA create a monorail that allows the suture loop to be positioned at the base of the appendage.