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Heart and Vascular Programs

Left Atrial Appendage Occlusion (LAAO)

Using implantable devices to treat atrial fibrillation

About LAAO

Left Atrial Appendage Occlusion (LAAO) is a procedure that uses implantable devices to replace the need for blood thinners and stops blood clots from entering the blood stream. WATCHMAN and Amulet are two devices commonly used in this procedure. In patients with atrial fibrillation (Afib), blood clots can form in the upper chambers of the heart, specifically in a small sac called the left atrial appendage (LAA).

The WATCHMAN™ and Amulet devices are both FDA-approved implants about the size of a quarter. The device is implanted into your LAA, closing the appendage off from the rest of your heart so blood clots can’t escape, lowering your risk of stroke. Your ChristianaCare heart team chooses which device is best for you based on your needs.

Why would I need a WATCHMAN™ or Amulet device?

The WATCHMAN™ and Amulet devices are approved for people who have Afib that is not caused by a heart valve problem, and who are:

  • At an increased risk of having a stroke from AFib.
  • Approved for short-term use of blood thinners after a surgery.
  • Unable to take long-term oral blood thinners.

How is a WATCHMAN™ or Amulet implanted?

The procedures to implant WATCHMAN and Amulet devices are minimally invasive. First you’ll be put to sleep under general anesthesia. Then your physician will insert a catheter (thin, flexible tube) through a small incision in your leg. They will guide it through a blood vessel to the heart’s left atrial appendage, where the tube will implant the device.

Your physician will use a transesophageal echocardiogram (TEE) during the procedure, which uses sound waves to scan the heart and make sure the device is working properly.

The procedure usually lasts less than one hour.

Group photo of the ChristianaCare LAAO team

What can I expect after an LAAO procedure?

Typically, you will leave the hospital the day after your LAAO procedure. After you go home, our team will continue to monitor you with regular follow-up appointments to make sure your recovery goes well. The recovery process right after the procedure includes:

  • No driving in the 24 hours or longer following the procedure.
  • Restricted activity the week after the procedure — no heavy lifting, climbing stairs, cycling, running, strenuous housework, or sexual activity.
  • Bruising where the catheter was inserted. The insertion site also might bleed a little. If this happens don’t panic, just lie down, and apply pressure to the wound until it stops.
  • Follow up appointments with your doctor, including a transesophageal echocardiogram to assess the healing and closing of your left atrial appendage, will be scheduled.

Your medical team will let you know specifics about when to call your doctor or 911. Your doctor will also give you specifics about when you can return to work and perform other activities. Timing depends on your specific situation, overall health, and type of work and lifestyle.

What are the risks and potential complications?

As with any operation, the LAAO procedure does carry some risks. Be sure to discuss all the possible complications the doctor performing the procedure. Your doctor will give you a more detailed overview of potential complications or side effects. There are some steps you can take to reduce your risk of complications, including:

  • Inform your team if you have an allergy or anesthesia or have had problems with anesthesia in the past.
  • Rest flat on your back for a few hours after the procedure to prevent bleeding at the injection site.
  • Make sure your doctor has a long history of implanting LAAO devices.
  • If you have any concerns, like bleeding, pain, or difficulty breathing, inform your doctor immediately.

Related Content

For the Love of Health Podcast

Learn more about the mechanics of atrial fibrillation, risks and care options, why a treatment technique called catheter-based ablation is becoming more common, why it is offering better outcomes for many patients, and why those results may be even easier to achieve in the coming years, on the ChristianaCare podcast, For the Love of Health.

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ChristianaCare Cardiology works as a team to provide the best cardiac care using state-of-the-art equipment and the latest procedures. From diagnosis to treatment, we are dedicated to your comfort and well-being.
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Get a Consultation

The Structural Heart Program at ChristianaCare has a team of dedicated physicians who can tell you if you are a good candidate for left atrial appendage occlusion to reduce the risk of stroke and improve your quality of life.

ChristianaCare Structural Heart Program

Christiana Hospital
4755 Ogletown-Stanton Road,
Newark, DE 19718