Anticoagulants not allowed

[Maxim10]

I am due to have the LAAO procedure because of the above. I had two subdural haematomas following my 1st ablation so the LAAO procedure is the only one open to me to miminise the risk of stoke. Have manymembers had the LAAO and did this cause much happiness!

Thanks,

Maxim10

[BobD Volunteer]

May have to wait till US comes on line as LAAO not available on NHS here in England although there was a small trial a while ago.

[Maxim10 in reply to BobD]

It is availabe at the John Radcliffe, surely. i am due to have mine done at the QE if this wretched vile, chinese (small 'c') virus abates.

Thanks.

[BobD Volunteer in reply to Maxim10]

Depends if you are talking Watchman or similar devise or surgical LAAO which may well be avaliable. Lariate procedure using keyhole surgery through the side to remove the LAA have been trialed I know.

[Gowers in reply to Maxim10]

I have never heard of this & didn't know they did this at the QE - i had 2nd ablation there in Feb - my follow-up appointment end of April has been cancelled to March 2021. I'm Hoping to get seen sooner but they told on Fri all planned surgery cancelled as cardioligists on call for emergencies only. Which cardiologist are you seeing?

[johnMiosh]

My LAA was excised by an Atriclip as part of a Minimaze ablation. It wasn't exactly pleasant, but the LAAO did not make the procedure any worse. The good thing was that the minimaze was successful (three years now without AF) and I thanks to the LAAO, I do not need anticoagulants.

[Maxim10 in reply to johnMiosh]

Thank you for your reply. Unfortunately, the terms you use are unfamilar to me so I would be extremely grateful if you be so kind as to explain further/ With many thanks, Maxim

[johnMiosh in reply to Maxim10]

The minimaze is an ablation done on the outside of the heart with access through the chest wall stopafib.org/mini-maze.cfm. This is quite an intesive procedure so recovery was not quick.

An atriclip is used to encircle the entrance of the LAA and close it off. Agai this is done through the chest wall. academic.oup.com/icvts/arti...

[Maxim10 in reply to johnMiosh]

Thank you for this. I have a few terms and procedures to discuss with my EP at pre-op assessment.

[Angie06]

Hi, I had mine done at St Barts on NHS 18mths ago due to not being able to take anticoagulant. I was due to have a Watchman but on the day of the procedure they used Amplatzer amulet device as it was a better fit and all went well. Recovery is very quick a few days for the groin to heal and after 12wks you have a camera (like endoscopy) to check if its settled and tissue grown over. Feeling a lot more confident as this affords some peace of mind. 😀

[Jajarunner in reply to Angie06]

I love the idea of it being a better fit, like a shoe or a coat!

[Angie06 in reply to Jajarunner]

🤣yes it has to fit the opening exactly.

[Maxim10 in reply to Angie06]

Hi Angie, so what is best:

to (1) have an 'appendectomy' to remove the damn silly appendage on the atrium or

(2) to block off the entrance to the appendage with the little 'umbrella' thus preventing

blood from pooling and clotting there. For (1), does the EP have to go in through the sie of the chest leaving not keyholes but stiched incisions ans scars.

With thanks,

Maxim

[Angie06 in reply to Maxim10]

Hi, no idea about '1' as only know what I had and the EP goes via the groin with 'umbrella' and camera down throat for precision as need to break through heart wall from right atrial to left. As I was out cold I never felt a thing 🤣

[Jajarunner]

It's definitely available again on NHS according to my EP at Papworth. But only at certain centres, nine of them, I think he said.

Not had it yet though....

[coco19]

I had surgical LLA excision as added extra to MVR and no anticoagulants.