In this presentation, Fermin C. Garcia, MD, reviews the current selection of investigatory devices developed to occlude or exclude the left atrial appendage (LAA) in patients at risk for clotting associated with atrial fibrillation. Beginning with the history of medical interest in the appendage, Dr. Garcia explains the rationale for these devices (up to 40% of AF patients have a contraindication for long-term anticoagulation), the pathophysiology of stroke and the issues with current therapy. He then describes the morphological differences in LAA structure between individuals, and the devices developed to occlude, exclude or remove the appendage, with their relative advantages and concerns.
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