Left Atrial Appendage Occlusion (LAAO)

Left atrial appendage occlusion (LAAO), also known as left atrial appendage closure (LAAC), is a minimally invasive procedure that places a small device to seal a pouch in the heart where clots often form in atrial fibrillation, helping lower stroke risk and, for many patients, reducing the need for long-term blood thinners.

You May be a Candidate if:

• You have AFib not caused by a heart valve problem (non‑valvular AFib).
• Your doctor says your stroke risk is elevated (often using a standard score like CHA₂DS₂‑VASc).
• Long‑term blood thinners are hard for you because of past bleeding, high fall risk, side effects, drug interactions, or trouble keeping up with monitoring.
• You can take a short‑term medication plan after the implant while the heart tissue heals over the device.

LAAO may not be right for everyone. People with certain heart valve conditions (like a mechanical valve), active infection, or left atrial appendage anatomy that doesn’t fit the device may need a different plan. Some patients who safely tolerate blood thinners long term may not need LAAO. Your electrophysiology specialist will review your history, images, and goals to decide with you.

• A small implant called a left atrial appendage occlusion (LAAO) device is placed to seal the left atrial appendage (LAA)—a common source of clots in AFib.
• The device is delivered through a catheter inserted in a leg vein; no chest incision.
• The goal is to reduce stroke risk and, for appropriate patients, allow discontinuation of long‑term blood thinners after healing and follow‑up imaging.

Benefits

• Lowers stroke risk by sealing the left atrial appendage, where many AFib‑related clots start.
• For the right patients, it may allow you to stop long‑term blood thinners after healing and follow‑up imaging (your doctor will confirm your plan).
• Minimally invasive: small puncture in a leg vein; most people go home the next day.
• Can mean fewer bleeding worries and fewer medication checks compared with lifelong anticoagulation.

Risks

• All procedures carry risk: bleeding, infection, or reactions to anesthesia/contrast dye.
• Heart‑specific risks can include fluid around the heart (pericardial effusion), device‑related clots, or the need to reposition or, rarely, remove the device.
• Vascular issues (bruising or bleeding) at the leg entry site.
• Short‑term medications are usually needed after the implant; some patients may still need longer‑term therapy based on imaging and risk.

How UC Health Reduces Risk

• Careful candidate selection using your history, bleeding and stroke scores, and detailed imaging of the LAA.
• Standardized protocols with ultrasound‑guided access and in‑procedure imaging to confirm fit and seal.
• Follow‑up imaging (often around 45 days) and close medication review to keep you safe.

LAAO is a personalized decision. Your care team looks at your stroke risk, bleeding risk, anatomy, and goals to decide together.

You’re More Likely to Benefit if you:

• Have non‑valvular AFib and an elevated stroke risk.
• Have trouble staying on long‑term blood thinners (bleeding, falls, medication side effects, or interactions).
• Can take a short‑term medication plan after the implant while the heart heals over the device.
• Have left atrial appendage anatomy that fits a current, FDA‑approved device.

LAAO May Not be a Fit if You:

• Have certain valve conditions (such as a mechanical valve) or active infection.
• Cannot safely undergo anesthesia or a catheter‑based heart procedure.
• Cannot take any short‑term antithrombotic therapy after the implant.

What Your Doctor Will Review

• Your medical history, prior procedures, and any bleeding events or falls.
• Current medications and potential drug interactions.
• Imaging of your heart to map the left atrial appendage.
• Standard tools that estimate stroke and bleeding risk.

To prepare for a consultation, bring your medication list, allergy list, and notes about any past bleeding, hospitalizations, or falls. We’ll discuss the pros and cons in plain language and decide the safest plan together.

At UC Health, we offer coordinated care tailored to your needs.

• Arrival and check‑in. We’ll confirm your name, allergies, and medications. You’ll change into a gown, meet your care team, and have an IV started.
• Pre‑procedure review. Your clinician will answer last‑minute questions and review the plan. Imaging is used during the procedure to guide placement (for example, ultrasound in the heart or a small camera in the esophagus).
• Anesthesia. Most people receive general anesthesia or deep sedation, so you won’t feel the procedure.
• The procedure. Through a small puncture in a leg vein, the doctor advances a thin tube to the heart and places the LAAO device at the opening of the left atrial appendage. The team checks position and seal before finishing. The procedure often takes under a couple of hours.
• After the procedure. You’ll wake up in a recovery area. Nurses will monitor your heart rhythm and the leg site. You’ll need to keep the leg still for a period so the vein can seal.
• Eating and moving. You can usually drink and eat when you’re fully awake. Staff will help you sit up and walk when it’s safe.
• Going home. Many patients stay in the hospital one night for monitoring and go home the next day. You’ll need a responsible adult to drive you.
• Before you leave. You’ll get simple instructions about activity, short‑term medications, and who to call with questions. We’ll also schedule your follow‑up imaging (often around 45 days).
• What’s normal. Mild soreness or bruising at the leg site is common. Call us right away for heavy bleeding, increasing swelling, chest pain, shortness of breath, fever, or any new or worsening symptoms.

Activity

• Expect mild soreness or bruising at the leg entry site. Walking is encouraged; avoid heavy lifting per your discharge instructions.
• Most people resume light work and daily activities within a few days to a week. Your doctor will personalize guidance.

Medications

• A short‑term antithrombotic plan is common after LAAO while heart tissue heals over the device. Your plan may include an anticoagulant and/or antiplatelet medicines.
• At the follow‑up imaging visit (often around 45 days), your clinician will review the seal and may adjust medications.

Appointments and Tests

• Follow‑up visit(s) with your care team to check your progress, review any symptoms, and confirm your plan.
• Imaging to confirm the device’s position and seal. Some patients may have additional imaging later based on risk and symptoms.

When to Call Your Provider

• New or worsening chest pain, shortness of breath, fainting, heavy or persistent bleeding, fever, or concerning leg‑site swelling/bruising.

• Coverage: Medicare and many commercial insurers cover LAAO for eligible patients with non‑valvular AFib who meet medical criteria. Coverage varies by plan.
• Prior authorization: Our team helps with benefits checks, documentation, and pre‑approval.
• Costs: Your out‑of‑pocket amount depends on your plan’s deductible, co‑insurance, and copays. We’ll review an estimate with you before scheduling.
• Referrals: If your insurer requires a referral, we’ll coordinate with your cardiologist or primary care clinician.

UC Health offers a high-volume LAAO program serving Greater Cincinnati, with protocols refined across many successful implants. Care is closely coordinated by specialists in electrophysiology, imaging, anesthesia, and neurology to ensure safe candidate selection, consistent procedures, and thorough follow-up imaging. With dedicated support from a program coordinator, patients receive clear guidance on education, scheduling, and follow-up at every step.

Call UC Health’s Cardiovascular team at 513-475-8521 to learn more.