Left Atrial Appendage Occlusion (LAAO)

Left atrial appendage occlusion (LAAO) is a minimally invasive surgical

procedure (carried out under general anaesthetic but without having to

make large incisions in the skin) which is thought to reduce the risk of

stroke in people with AF. During the procedure the mouth of the LAA is

blocked using a plug-like occlusion device which is introduced into the

heart through a vein in the groin.

LAA Occlusion

(Dr Sumanto Mukhopadhyay)

done under General Anaesthetic

T.O.E. (Trans-Oesophageal Echocardiography) guidance

1      Barts angiopack

1 8F Femoral Sheath

1 6F Pigtail catheter

1 6F MPA1 diagnostic catheter

1 Amplatz Super Stiff straight-tip (short taper) wire 0.035” x 260cm

1 Prostyle

1 Hemostasis valve or Y-connector

1 12Fr Amulet delivery sheath

1 500mL Saline bag

1 Spike

1 Backstop

1 10mL Heparin (10,000iu)

1 10ml Lidocaine 1%

1 Ultrasound probe cover

Transseptal Puncture:

1 BRK transseptal needle

1 SL1 sheath

Procedural Steps:

Right femoral venous access

Insert 8F femoral sheath then preclose with Prostyle then upsize to 14Fr sheath

Introduce Transseptal puncture kit (SL1 + BRK)

Once across the left atrium, remove needle and introduce MPA1 catheter with guidewire

With TOE guidance, cross the mouth of left atrial appendage, park the MPA1 catheter and remove the guidewire and replace with Amplatz stiff wire J-tip 260cm

Remove MPA1 catheter and replace with occlusion device of choice

Once deployed, check placement with contrast

Remove delivery system and close groin with Prostyle.

-rodnie 21/02/23