Left Atrial Appendage Closure

The left atrial appendage (LAA) of the heart is a common location where clots form in atrial fibrillation (AFib) patients that then embolism and cause a stroke. Closing off the LAA either surgically, with a clip or via transcatheter LAA closure device, closes the opening to the LAA to prevent clots from forming or embolizing. The clots are the reason why AFib patients need to be on anticoagulants. LAA occlusion (LAAO) enables patients to stop taking anticoagulation drugs. LAAO has been a rapidly growing segment of structural heart procedures since the approval of the first device, the Watchman, in 2015. Procedures are performed by electrophysiologists, interventional cardiologist or cardiac surgeons.

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CT has been used for planning and procedural guidance in pulmonary vein isolation (PVI) for about 20 years. It shows the anatomy to the electrophysiologist. The EPs also can load the imaging into their EP mapping system. It also shows them the location of the esophagus and the phrenic nerve so they can avoid these during the procedures. #PVI #EPeeps

VIDEO: The expanding role of cardiac CT in electrophysiology

Harold Litt, MD, division chief of cardiothoracic imaging and director of the Center for Advanced CT Imaging Sciences at the Perelman School of Medicine of the University of Pennsylvania, explains the role of cardiac CT in EP procedures.

A FEOPS image of a Watchman LAA occluder device being checked for virtual sizing in an anatomical model of the patient's left atrial appendage. Dhanunjaya Lakkireddy, MD, explains the role and technology of LAA closure devices in managing AFib patients.

VIDEO: The value of left atrial appendage occlusion in AFib patients

Dhanunjaya Lakkireddy, MD, executive medical director for the Kansas City Heart Rhythm Institute at HCA Midwest Health, explains recent trials in left atrial appendage occlusion (LAAO) and how the therapy helps atrial fibrillation (AFib) patients. 

Interview with Rebecca T. Hahn, MD, Professor of Medicine at Columbia University Irving Medical Center, Chief Scientific Officer of the Echo Core Lab at the Cardiovascular Research Foundation and Director of Interventional Echocardiography at the Columbia Structural Heart and Valve Center. She discusses some of the trends of growing use of interventional echocardiographic guidance in transcatheter structural heart procedures, the growing number of tricuspid valve procedures, and use of 3D ICE.

VIDEO: Trends in structural heart procedural imaging - a discussion with Rebecca Hahn

Rebecca T. Hahn, MD, Director of Interventional Echocardiography at the Columbia Structural Heart and Valve Center, discusses some of the trends in the growing use of interventional echocardiographic guidance in transcatheter structural heart procedures.

Watchman FLX left atrial appendage closure (LAAC)

Boston Scientific gains a new FDA approval for Watchman FLX LAAC device

The company can now update its labeling instructions for the device to include a new 45-day dual anti-platelet therapy treatment option when treating non-valvular atrial fibrillation. 

Pre-procedure CT imaging benefits LAA occlusion in Henry Ford study

There is not agreement among the top structural heart experts if CT is required for left atrial appendage occlusion (LAAO), but a Henry Ford Hospital study shows it can improve outcomes.

View of an Amulet left atrial appendage (LAA) occluder on 4D intra-cardiac echo (ICE) from a GE NuVision ICE catheter. Since ICE is operated by the interventionalist, it can be used to reduce the number of people needed to perform an LAA occlusion procedure.  

New LAA occluder technology and the debate on echo vs. CT image guidance

At TVT 2022, there was debate whether CT imaging is needed for preplanning LAA procedures, and several new devices in development were discussed.

Two examples of new left atrial appendage occluders (LAAO), the Conformal omn left and the Laminar on the right. evi Nair, MD, FACC, FHRS, director of cardiac electrophysiology at St. Bernard's Healthcare, Jonesboro, Arkansas, explains some of the recent advances in transcatheter left atrial appendage (LAA) occlusion technology at the 2022 Transcatheter Valve Therapeutics (TVT) Structural Heart Summit. #TVT #TVT2020 #LAA #LAAO #EPeeps

VIDEO: Advances in left atrial appendage occlusion technology

Devi Nair, MD, director of cardiac electrophysiology at St. Bernard's Healthcare, Jonesboro, Arkansas, explains some of the recent advances in transcatheter left atrial appendage (LAA) occlusion technology at the 2022 Transcatheter Valve Therapeutics (TVT) Structural Heart Summit.

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What peridevice leaks after LAAO mean for patient health

The study's authors reviewed data from more than 50,000 patients, presenting their findings in JACC: Clinical Electrophysiology.

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