Left atrial appendage occlusion (LAAO): Modern cardiac care for atrial fibrillation
Written by:Nottingham University Hospitals (NUH) has launched a new service utilising state-of-the-art cardiac care to reduce the risk of stroke in patients who have atrial fibrillation.
Here to provide his expert insight into this new procedure, called left atrial appendage occlusion (LAAO), is Dr Ashan Gunarathne, renowned consultant interventional cardiologist at NUH and associate professor.
What is atrial fibrillation?
Atrial fibrillation is a cardiac condition characterised by an irregular and frequently abnormal fast heart rate that affects approximately 1.4 million people in the UK, putting them at significant risk of stroke.
How can LAAO help to manage atrial fibrillation?
LAAO is a structural interventional surgical procedure designed to close a small pouch in the heart where 90 per cent of blood clots form, using a device such as a Watchman or Amulet, which is inserted percutaneously (minimally invasive).
During the LAAO procedure, a catheter is inserted through a vein in the leg and guided to the heart. Using advanced imaging techniques, the catheter is manoeuvred into the left atrium of the heart and directed towards the left atrial appendage, the pouch where blood clots frequently form in patients who have atrial fibrillation.
A closure device, such as the Watchman or Amulet, is then delivered through the catheter and deployed to seal off the left atrial appendage. This device effectively blocks the appendage, preventing blood clots from forming and entering the bloodstream. Once in place, the device is carefully checked to ensure it is securely anchored. Lastly, the catheter is removed.
LAAO has been shown to significantly reduce the risk of stroke by two-thirds, comparable to the effect of anticoagulants, but without the long-term risk of bleeding associated with these blood-thinning medications.
Who is a suitable candidate for LAAO?
Currently, LAAO is approved only for people at high risk of stroke who cannot take anticoagulants. LAAO, however, is available in only a limited number of centres in the UK, like the Trent Cardiac Centre located at City Hospital.
In 2022, I successfully performed this procedure on two of our patients at NUH using the Watchman Device for the first time. Working closely with the industry, my cardiology interventional team and my cardiology management team since intended to expand our capabilities over the next couple of years to serve a larger proportion of patients.
If you would like to schedule an appointment with Dr Ashan Gunarathne, head on over to his Top Doctors profile today.
