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.

Vendor payments not responsible for rising popularity of LAAO procedures
Consulting fees and other vendor payments do not appear to be directly influencing U.S. physicians to implant more Watchman devices. Researcher Alexander Kolomaya, MD, discussed his team's findings on this topic.
Abbott’s Amulet LAAO device linked to long-term safety, effectiveness
Researchers explored five-year data from more than 1,800 patients with nonvalvular AFib who underwent LAAO with Abbott's Amulet or Boston Scientific's Watchman 2.5.
Key details on the use of ICE to guide structural heart procedures
Scott Lim, MD, details his experience using intracardiac echo to help guide structural heart procedures with or without traditional TEE. One key benefit of ICE, he explained, is its ability to overcome imaging challenges posed by prior cardiac surgeries.
LAAC with Watchman FLX reduces bleeding risks after AFib ablation
The new data, presented during AHA Scientific Sessions 2024, suggest LAAC with Boston Scientific's Watchman FLX could be a safe, effective alternative to OAC for limiting post-ablation strokes.
LAAO with Watchman FLX associated with positive 1-year outcomes, real-world data confirm
Researchers hoped to gain a better understanding of the device's real-world impact by reviewing registry data from more than 97,000 U.S. patients. Overall, the Watchman FLX was linked to positive data and limited adverse events one year after treatment.

a 3D intracardiac echo (ICE) view of a surgical mitral valve using the GE NuVision ICE system.

Can intracardiac echo replace TEE during structural heart procedures?

TEE has been used to guide most transcatheter structural heart cases over the past decade, but 3D ICE is changing how some centers image those patients.

Most devices implanted during LAAO procedures are oversized—and patients benefit

Oversized devices are becoming more common as time goes on, which suggests operators are growing increasingly comfortable with this treatment choice.

LAAO equally effective for men and women, new long-term study confirms

In-hospital complications are more common among women who undergo LAAO than men. However, according to a new study in JACC: Cardiovascular Interventions, men and women have similar long-term outcomes.

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.

Left Atrial Appendage Closure

Vendor payments not responsible for rising popularity of LAAO procedures

Abbott’s Amulet LAAO device linked to long-term safety, effectiveness

Key details on the use of ICE to guide structural heart procedures

LAAC with Watchman FLX reduces bleeding risks after AFib ablation

LAAO with Watchman FLX associated with positive 1-year outcomes, real-world data confirm