What is it?
A left atrial appendage occlusion procedure is an alternative to long-term anticoagulant treatment to prevent stroke in people with a history of atrial fibrillation (AF) who do not have rheumatic heart valve problems and have problems taking blood thinners. During atrial fibrillation, the upper chambers of the heart quiver rapidly and their usual pumping action is compromised. This may allow blood to stagnate and blood clots to form inside the heart. Over 90% of blood clots tend to form within a blindending pocket of the heart called the left atrial appendage.
Studies have shown that if a plug device can be inserted into the blindending pocket to seal it off completely, the risk of stroke can be lowered to a similar level as when taking long term blood thinner therapy (PROTECT AF Study, The Lancet, August 2009).
How successful is the procedure?
Small numbers of patients may not be able to have the plug device successfully implanted into their left atrial appendage. This may occur because the anatomy of the blindending pocket will not permit a correct fit and seal of the opening or if there is a blood clot present. In the majority of cases, this can be identified using tests (such as a CT scan or transoesophageal echocardiography) prior to the procedure.
What should I expect?
The procedure is performed under a general anaesthetic. While you are asleep, small incisions are made in the groin and a catheter is passed up through the veins into the heart. Continuous ultrasound pictures are created by transoesophageal echocardiography to guide the correct positioning of the equipment within the heart. A small puncture is made inside the heart to advance the equipment across into the left atrium where the plug will be positioned.
First, a catheter is carefully positioned inside the left atrial appendage and dye injections are performed to best assess how and where the plug should be finally positioned. When the occluder device is deployed, it springs out into shape from inside the catheter.
Once the procedure is complete, the catheters are withdrawn from the groin and pressure is applied to seal over the incisions. You will be taken to recovery and then back to your ward bed for monitoring overnight. You will be asked to lie still for several hours to prevent any bleeding from the groin.
An important safety consideration is the prevention of blood clots on the catheter during the procedure or inside the heart during the healing period. Blood clots can potentially travel into the blood stream and cause stroke. You may be required to take blood thinner treatment before and for several weeks after the procedure. Your cardiologist will use additional blood thinners during the implant.
Preparation
Do not eat or drink anything for 6 hours prior to your procedure. A CT scan of your heart or transoesophageal echocardiogram may be performed before your procedure. Make sure you read the consent form and understand the risks involved with this procedure. Please clarify any concerns or queries about this procedure with your cardiologist before signing this form.
What happens after the procedure?
In the first 24 hours after your procedure, it is common to have some minor bruising and discomfort at the incision sites in the groin. You should avoid exercise and heavy lifting for the first few days, and then resume normal activities after the first week. You will receive instructions on the best blood thinner treatment for you after your procedure.
A further ultrasound test (transoesophageal echocardiogram) will be arranged a few weeks after your procedure to check that the plug has healed in satisfactorily.
Search for a centre near you
Regional Cancer Centre, Corner of Borella Road and East Street, East Albury, NSW, 2640
(02) 6043 7800
3056 Albany Hwy, Suite 10, Armadale Hospital Specialist Centre, Armadale WA 6112
(08) 9391 1234
Cardiac Investigations Unit, Bundaberg Base Hospital, Bourbong Street, Bundaberg West, QLD, 4670
(07) 4199 7300
St John Of God Berwick Specialist Centre, 55 Kangan Drive, Berwick VIC 3806, Australia
(03) 8794 2700
Buderim Private Hospital, 12 Elsa Wilson Drive, Buderim QLD 4556
1800 155 225
Suite 21, St John of God Hospital, Southwest Health Campus, Corner of Roberston Drive & Bussell Highway, WA, 6230
(08) 9720 3400
South West Health Campus, Corner of Bussell Hwy & Roberston Drive, Bunbury, WA 6230
(08) 9726 6400
Suite 21, St John of God Hospital, Southwest Health Campus, (Cnr Robertson Drive & Bussell Hwy), Bunbury WA 6230
(08) 9720 3403
Bundaberg, Mater Hospital (Oncology), 313 Bourbong Street, Bundaberg, QLD, 4670
(07) 4154 9900
Suite 3, Entrance 1, 72 Barolin Street, Bundaberg, QLD 4670
(07) 4199 7080
Mater Misericordiae Hospital, 313 Bourbong Street, Bundaberg West, QLD, 4670
(07) 4199 7080
Health and Wellness Centre Level 1, Suites 8-10, 20 Scholar Drive, Bundoora, VIC, 3083
(03) 8467 5900
Cabrini Hospital Malvern, Level B4, Gandel Wing, 183 Wattletree Road, Malvern, VIC 3144
(03) 9597 6900
Calvary Central Districts Hospital, Jarvis Road, Elizabeth Vale SA 5112, Australia
(08) 7285 6400
Hervey Bay Hospital, Corner of Nissen Street & Urraween Road, Urraween QLD 4655
(07) 4303 4351
Chermside Medical Complex, Lower Ground Floor, 956 Gympie Road, Chermside QLD, 4032
(07) 3917 4400
Cockburn Health & Community Centre, Level 1, Suite 11, 11 Wentworth Parade, Success WA 6164
(08) 6332 2300
Cockburn Health & Community Centre, Level 1, Suite 11, 11 Wentworth Parade, Success WA 6164
(08) 9233 5200
Central Highlands Healthcare Ltd. Trading as Emerald Medical Group Lot 1, Pilot Farm Road, Emerald QLD 4720
(07) 3858 8690
Epping Medical Centre, Ground Floor, 230 Cooper Street, Epping, VIC, 3076
(03) 9409 8000
Flinders Private Hospital, Level 2, 1 Flinders Drive, Bedford Park, SA 5042
(08) 8179 5500
Fraser Coast, St Stephen’s Private Hospital, 1 Medical Place, Urraween, QLD, 4655
(07) 4120 6600
Suite 3, Level 1, Building 1, 49 Frenchs Forest Road, Frenchs Forest NSW 2086
(02) 8030 6700
Floor 1, 19-23 Bingera Street, Bundaberg QLD 4670
(07) 4199 7300
Mater Hospital (Outpatients Department), 50 Rosella Street, Gladstone, QLD, 4680
(07) 3858 8690
Mater Misericordiae Hospital, 50 Rosella St, Gladstone QLD 4680
(07) 4199 7080
Ramsay Specialist Centre Suite 212, Level 2 Newdegate Street, Greenslopes, QLD, 4120
(07) 3255 7200
Gympie Specialist and Diagnostic Centre, 74 - 76 Channon Street, Gympie QLD 4570
(07) 5390 3700
Suite 1, Warringal Private Hospital, 216 Burgundy Street, Heidelberg VIC 3084
(03) 9455 4800
Hollywood Private Hospital, Diagnostic Nuclear Imaging, Monash Ave, Nedlands WA 6009
(08) 9438 8500
Jimboomba Medical Centre Shop 14, Jimboomba Shopping Centre Mt Lindesay Highway Jimboomba, Qld, 4280
(07) 3255 7200
John Flynn Private Hospital, 42 Inland Drive, Tugun QLD 4224
Level 3, Shenton House, 57 Shenton Avenue, Joondalup, WA 6027
(08) 9400 6161
Shenton House, Level 3, 57 Shenton Avenue, Joondalup, WA 6027
1300 977 062
Level 2 & 3, 57 Shenton Avenue, Joondalup WA 6027
(08) 9233 5200
Suite 103, Specialist Medical Centre West, Grand Blvd & Shenton Ave, Joondalup, WA, 6027
(08) 9233 5200
Karratha Health Campus Outpatients Department 62 Balmoral Road KARRATHA WA 6714
(08) 9144 7777
Lady Bjelke-Petersen Community Hospital (formerly South Burnett Private Hospital), 31 Markwell Street, Kingaroy QLD 4610
(07) 3858 8690
Langwarrin Suites 1 & 2, 35 Cranbourne-Frankston Road, Langwarrin VIC 3910
(03) 8769 5800
Mackay Rehabilitation Hospital, 57 Norris Road, North Mackay, QLD, 4740
1800 155 225
Hospital Building, Suite 1, Level B2, 3 Technology Place, Macquarie University, NSW, 2109
(02) 9812 3220
Margaret River Surgery, 1 Station Road, Margaret River WA, Australia
9720 3400
Margaret River Surgery, 1 Station Road, Margaret River WA, Australia
9720 3400
St Stephen's Medical Centre Suite 2, 166 John Street Maryborough QLD 4650
(07) 4303 4300
Mater Private Clinic Suite 5.02 & 5.11, Level 5 550 Stanley Street South Brisbane QLD 4101
(07) 3360 7100
The Mater Hospital, 25 Rocklands road, North Sydney, NSW
(02)9458 8050
Mount Ommaney Medical Centre Shop 6/171 Dandenong Road Mt Ommaney QLD 4074
(07) 3725 3900
Mulgrave Private Hospital, Suite 8, Churchill Consulting Suites, Blanton Drive, Mulgrave, VIC, 3170
(03) 8793 3800
St John of God Wexford Medical Centre, Level 4, Suite 68-72, 3 Barry Marshall Parade, Murdoch, WA 6150
(08) 6332 2300
Suite 59, SJOG Medical Centre Barry Marshall ParadeMurdoch WA 6150
Suite 68-72 Wexford Medical Centre, Level 4, 3 Barry Marshall Parade, Murdoch WA 6150
(08) 9233 5200
10 Mapleton - Nambour Road, Nambour QLD, Australia
(07) 5374 8100
Suite 20/21 Hollywood Medical Centre, 85 Monash Avenue, Nedlands WA
(08) 6389 9100
Suite 20/21 Hollywood Medical Centre, 85 Monash Avenue, Nedlands WA 6009
(08) 9233 5200
Lake Imaging Specialist and Research Centre 14-20 Blackwood Street North Melbourne 3051
(03) 9813 7950
St Andrew’s Hospital, North Street, Spring Hill, QLD, 4000
(07) 3832 1717
Level 2, 2-9 Village Way, Lakeside Square Medical Precinct, Pakenham VIC 3810
(03) 8793 3800
Level 4, Suite 22, Melbourne Private Medical Centre, Royal Parade, Parkville VIC 3052
(03) 9813 7950
Suite 53/ 146 Mounts Bay Road, Perth WA 6000 Australia
Suite 3 Mount Medical Centre, Level 3, 140 Mounts Bay Road, Perth WA 6000
(08) 9233 5200
Pindara Specialist Suites Suite 4.07, Level 4, 29 Carrara Street, Benowa QLD 4214
Pindara Private Hospital, Allchurch Avenue, Benowa QLD 4217
Pulse Oceanside Medical, Suite 402, 11 Eccles Boulevard, Birtinya, QLD 4575
(07) 5322 5900
Ringwood Private Hospital, 36 Mount Dandenong Road, Ringwood East VIC 3135
(03) 8870 3300
RiverCity Private Hospital, Level 4, 401 Milton Road, Auchenflower, QLD, 4066
Mater Hospital (Outpatients Department) 31 Ward Street Rockhampton QLD 4700
(07) 3858 8690
Rockhampton Hospital, Lower Ground Floor, Canning Street, Rockhampton, QLD, 4700
(07) 4932 5000
Elanora Dr, Rockingham General Hospital, Cooloongup WA 6168
Priority Health Orion Shopping Centre, 1st Floor, 1 Main Street, Springfield QLD 4300
(07) 3858 8690
St Andrew's Hospital, 352 South Terrace, Adelaide, SA 5000
(08) 8228 6700
St Andrew's Medical Centre Clinic, Level 2. 321 South Terrace, Adelaide, SA 5000
(08) 8202 6644
St Andrew's Hospital Toowoomba, 280 North Street, Toowoomba, QLD 4350
St Stephen's Hospital, 1 Medical Place, Urraween Fraser Coast, QLD, Australia
(07) 4199 7080
St Vincent's Hospital, Basement Level, Building C, 41 Victoria Parade, Fitzroy, VIC, 3065
(03) 9427 6500
St Vincent's Private Hospital, Toowoomba, Scott Street, Toowoomba City QLD 4350
(07) 3858 8600
St Vincent's Private Hospital, Scott Street, Toowoomba, QLD 4350
Suites 14 & 15, Sunshine Coast University Private Hospital, 3 Doherty Street, Birtinya QLD 4575
(07) 5390 3700
Sunshine Coast University Private Hospital Suite 20/3 Doherty St, Birtinya QLD, 4575
(07) 5437 9788
Level 1, Suite 10 St Stephen's Private Hospital, 1 Medical Place, Urraween QLD 4655
(07) 4303 4300
Vermont Consulting Clinic, Vermont South Medical Centre, Level 3, Suite 3-5a, 645-647 Burwood Hwy, Vermont South, VIC, 3133
(03) 9210 8300
Level 5, Suite 91 Sandford Jackson Building 30 Chasely Street Auchenflower QLD 4066
(07) 3858 8650
The Wesley Hospital, Auchenflower, QLD, 4066
1800 155 225
The Wesley Medical Centre, 1/40 Chasely St Auchenflower, Brisbane, QLD, 4066
Westside Private Hospital, Suite 309, Level 3, 32 Morrow Street, Taringa, QLD, 4068
(07) 3022 7850
Royal Street Specialist Centre, Cnr Royal Street & Wanneroo Road, Yokine, WA 6060
0894803000
Royal Street Specialist Centre, Cnr Royal Street & Wanneroo Rd, Yokine WA 6060
(08) 9233 5200