What is Left Atrial Appendage Closure (LAAC)?

Blessing Health offers two brands of Left Atrial Appendage Closure devices; WATCHMAN and Amulet. Both implants are left atrial appendage closure device for patients with atrial fibrillation not caused by a valve problem (NVAF) who need an alternative to oral anticoagulation. 

  • Left Atrial Appendage Closure is a one-time minimally invasive procedure that may provide a lifetime of stroke-risk reduction without the bleeding risk associated with long-term anticoagulation.
  • LAAC has a 95% procedural success rate with a low 1.5% major complication rate.
  • Total out-of-pocket spending for LAAC procedures is lower than Warfarin by year two and half the cost by year five.
  • LAAC is a percutaneous procedure performed in the catheterization lab with general anesthesia and takes about an hour with a typical length of stay of 24 hours.
  • Post-procedure therapy includes Warfarin + ASA (81-100mg) daily, with 45 days* TEE and Clopidodrel (75mg) + ASA (300-325mg) daily.
    • * If adequate seal is not demonstrated, (leak > 5mm) at 45-day follow-up, assess seal with TEE at 6 months.
  • Destination therapy involves 6 months TEE, along with ASA (300-325mg) daily.

Who It Is For

  • Patients with atrial fibrillation not caused by a valve problem (NVAF).
  • Patients with an increased risk for stroke (CHA2DS2VASc of ≥ 2 or CHA2DS2VASc of ≥ 3 for Medicare patients) and are recommended for oral anticoagulation.
  • Patients who need an alternative to long-term blood thinners due to history of serious bleeding while taking blood thinners, lifestyle, occupation or a condition that puts them at risk for serious bleeding, or currently taking Warfarin and having trouble with the treatment plan.
  • Patients must be suitable for short-term Warfarin therapy post-procedure.

Our Structural Heart Navigator Program

Being diagnosed with a heart condition is overwhelming. At Blessing, our Structural Heart Navigator is specially trained and experienced in Structural Heart care, and offers individualized support to help guide, educate, and encourage the patient, their family and caregivers through their heart care journey. Some of these features include the following:

  • Familiarity with the local network of physicians, collaborating with providers for seamless care.
  • Accessing a network of community resources to eliminate barriers such as transportation needs.
  • Facilitate scheduling appointments and testing.

The Navigator’s services are free of charge and are tailored to the needs of each patient. You can click here for more details about Blessing Hospital's Structural Heart Navigator Program and how it can work for you.

For Referring Providers

The patient is required to see a second provider other than Interventional Cardiology prior to the procedure in order to participate in Shared Decision Making. This could include you as a Non-Interventional Cardiologist, Primary Care Physician, Neurologist, Gastroenterologist, or other Provider who thinks a Left Atrial Appendage Closure procedure could benefit their patient. Shared Decision Making includes a conversation with the patient to review atrial fibrillation and stroke treatment options, documentation of the CHA2DS2VASc of ≥ 2 (or CHA2DS2VASc of ≥ 3 for Medicare patients) and rationale to seek a non-pharmacologic alternative to Warfarin: history of major bleeding while taking therapeutic anticoagulation, patient’s inability to maintain a stable INR, a medical condition, occupation or lifestyle placing the patient at high risk of major bleeding secondary to trauma.