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.
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
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
LARIAT® Suture Delivery Device
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.