Prior to Procedure

Your doctor may do the following:

• Physical exam, including blood and urine tests
• Chest x-ray
• ECG —a test that records the electrical activity of the heart
• Transesophageal echocardiography (TEE)—a test that takes images of your heart, may be needed to help choose the size of the device that will be used

In the days leading up to your procedure:

• Talk to your doctor about your medications, including over-the-counter medications. You may be asked to stop taking some medications up to 1 week before the procedure.
• Arrange for someone to drive you home from the hospital and help you out at home.
• Eat a light meal the night before. Do not eat or drink anything after midnight.
• Avoid smoking.

Anesthesia

Local or general anesthesia may be used. Local anesthesia will numb where the catheter is inserted. With general anesthesia, you will be asleep during the procedure. You may also be given a sedative before the procedure to help you relax.

Description of the Procedure

This method only needs a small incision which can decrease risks and recovery time compared to open procedures with large incisions.

A small incision will be made over a vein in the groin. A tube called a catheter will be placed into the vein and passed through blood vessels to the heart. An imaging machine will help the doctor see exactly where the catheter is in the body.

Tools or devices will be passed through the catheter to complete the work. The exact steps will depend on the type of LAAC. Some options include:

• Placing a device in the LAA to block off the area. The device will also catch any blood clots that already exist before they pass out of the heart. Over time, tissue will form over the filter to seal it.
• The area is closed off with wire and stitches to keep blood out.

Once the procedure is done the catheter(s) will be removed. Pressure will be applied to the incision to stop bleeding and a bandage will be placed over the area.

How Long Will It Take?

1-2 hours

Will It Hurt?

Anesthesia will prevent pain during the procedure. You will have some pain in the chest and at the insertion site after the procedure. Your doctor will recommend medications to help manage the pain.

Post-procedure Care

At the Care Center

Right after the procedure, a weight will be placed over your leg for a time to help the vein close. The staff will check your vital signs and monitor you for any bleeding.

Images will be taken to ensure the device is correctly placed.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

• Washing their hands
• Wearing gloves or masks

There are also steps you can take to reduce your chance of infection such as:

• Washing your hands often and reminding visitors and healthcare providers to do the same
• Reminding your healthcare providers to wear gloves or masks

At Home

Most will return to normal activities within the first few days. Follow-up visits will be needed starting at 45 days to make sure the area has sealed off. Once the area is sealed, anticoagulant medication can be stopped. Most will be able to stop medication by 1 year. Yearly tests will be needed to make sure the closure device is in place.