LA Appendage

Left atrial appendage (LAA) closure is a procedure that blocks or closes the opening to your LAA to keep blood clots from leaving there and going into your bloodstream. This prevents strokes in people with atrial fibrillation, but without blood thinners. This appendage in one of your heart’s upper chambers doesn’t have a function.

What is left atrial appendage closure?

Left atrial appendage closure is a surgical or minimally invasive procedure to seal off your left atrial appendage (LAA), a small sac in the muscle wall of your left atrium (top left chamber of your heart. Removing it or closing it off can reduce your risk of stroke and eliminate the need to take blood thinning medication.

Studies have shown that, among people with atrial fibrillation who don’t have valve disease, most of the blood clots that happen in the left atrium start in the LAA.

It’s unclear what function, if any, the left atrial appendage performs. Your heart can continue to do its job with a closed left atrial appendage.

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

In someone who has atrial fibrillation, the electrical impulses that control the heartbeat don’t travel in an orderly way through your heart. Instead, many impulses begin at the same time and spread through the atria. The fast and chaotic impulses don’t give your atria time to contract and/or effectively squeeze blood into your ventricles.

Because the left atrial appendage is a little pouch, blood collects there and can form clots in the LAA and atria. When your heart pumps out blood clots, they can cause a stroke. People with atrial fibrillation are three to five times more likely to have a stroke than the general population.

What happens during left atrial appendage closure?

During surgery for coronary artery disease or valve disease, your healthcare provider can remove your left atrial appendage and sew the area closed. They may staple it closed instead. This is a surgical left atrial appendage closure.

In a minimally invasive approach, they can use a catheter to insert a special device to close or block your left atrial appendage. These devices may act as a plug in your left atrial appendage’s opening to your left atrium. Other devices tie or clamp your left atrial appendage closed.