Left Atrial Appendage Closure — WATCHMAN

In patients with atrial fibrillation, the left atrial appendage — a small pouch
in the upper left chamber of the heart — is the site where over 90% of cardiac blood clots form.
These clots can travel to the brain and cause stroke.

Standard treatment involves long-term anticoagulant medication (blood thinners)
to prevent clot formation. However, some patients cannot tolerate anticoagulants
due to high bleeding risk, prior major bleeding, or other medical conditions.
For these patients, closing the left atrial appendage physically is an alternative strategy.

WATCHMAN is a small plug-like device delivered through a catheter inserted
into the femoral vein in the groin. Under general anaesthesia and guided by
transoesophageal echocardiography, the device is positioned within the left atrial appendage
to seal it off. The procedure takes approximately one to two hours.
Over time, the heart’s own tissue grows over the device, permanently sealing the appendage.

Following the procedure, a short course of anticoagulation is usually required
while the device surface heals. Long-term anticoagulation can typically
be discontinued after approximately 45 days, subject to echocardiographic confirmation.

WATCHMAN may be appropriate for patients with atrial fibrillation who have
an elevated stroke risk score (CHA₂DS₂-VASc ≥2) and meet one or more of the following:

Suitability is confirmed by transoesophageal echocardiography and Heart Team review.
Anatomical assessment of the left atrial appendage is essential before the procedure.

Appointments are required in principle. A referral letter from another medical institution is recommended but not mandatory.

For appointment requests and language support, please see the
Cardiology page.