The most serious risk from atrial fibrillation is thromboembolic stroke. The left atrial appendage (LAA) is a pouch-like extension of the left atrium about the size of your thumb with a narrow opening into the left atrium. With atrial fibrillation, blood can pool and form clots in this appendage. If a blood clot breaks loose it may travel through the blood vessels and eventually plug a smaller vessel in the brain or heart.
Doctors often prescribe the blood thinning medications such as Coumadin to prevent blood clots, however, it can often cause serious side effects. Today, the doctors at PHCVI can offer many patients an alternative such as the Watchman Device and Lariat procedure to prevent blood clots associated with atrial fibrillation.
What is the Watchman Device?
The Watchman Device is a small, fabric-covered device permanently placed in the opening of the left atrial appendage to prevent harmful-sized blood clots from exiting and entering the bloodstream. It is made of materials that are well-tolerated by most patients, and intended for those with non-valvular atrial fib, who require treatment for potential blood clotting and can tolerate Coumadin.
Watchman LAA closure is performed under local or general anesthesia in the cathaterization lab. The heart is reached through a hole made in the femoral vein in the upper thigh and the device is delivered to the LAA through a catheter under x-ray and ultrasound guidance. The procedure takes about an hour and requires an overnight hospital stay.
It takes at least 45 days for the heart tissue to heal. It will be important to continue taking Coumadin (your doctor will prescribe a lower dosage) and a daily aspirin. Your physician may also prescribe an antibiotic to prevent infection after surgery.
What is the Lariat Procedure?
This permanent, one-time procedure has been found to be highly successful and poses fewer risks and less discomfort to patients than surgery.
Performed under general anesthesia, the Lariat procedure uses two catheters carrying the Lariat Suture Delivery Device. One of these catheters is inserted under the patient’s rib cage; the other is sent to the heart’s left atrial appendage (LAA). Once the catheters are in place, the device places and then tightens a loop stitch around the base of the left atrial appendage, sealing it off from the rest of the heart, blocking stroke-causing blood clots from traveling to the brain.
Benefits of the Lariat Procedure
The Lariat procedure is a minimally invasive procedure that:
Can reduce the risk of stroke by 85 to 90 percent
Is suitable for patients who cannot undergo surgery
Minimizes discomfort and promotes faster healing and quicker recovery