The LARIAT Suture Delivery Device is a suture-based device used to occlude left atrial appendage. By means of a standard techniques, similar to ones used in left atrial ablation procedure, a magnetic wire is placed inside of the left atrial appendage. Then, via a percutaneous epicardial approach, a second magnetic wire is placed in the sac of the heart (pericardial space) from outside by doing a tiny puncture below the breastbone. This second wire then finds the first magnetic wire in the LAA. Next, over this magnetic wire bridge, a LARIAT suture is inserted over the wire in the pericardial space to find the LAA and snare it, ultimately resulting in necrosis of the LAA. Following the procedure, the only thing that remains in the body is a suture ligating the LAA. The patient is observed overnight in the hospital and discharged the next day.
TO PREPARE FOR LARIAT DEVICE PROCEDURE:
- Ask what medications you are allowed to take. We may also ask you to stop other medications (such as Coumadin (warfarin) and/or aspirin products) several days before your procedure. Your INR (a blood test to evaluate blood clotting) must be within a suitable range to undergo the procedure. If you have diabetes, ask our office how you should adjust your diabetic medications.
- Do not eat or drink anything after midnight the evening before your procedure. If you need to take medications, drink only with a small sip of water.
- When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home.
WHAT TO EXPECT:
- The implant will take place in a special room called the cardiac catheterization or EP (electrophysiology) lab. Before the test begins, a nurse will help you get ready. You will lie on a bed and the nurse will start an IV (intravenous) line. This is so the doctors and nurses can give you medications and fluids during the procedure.
- The nurse will connect you to several monitors. Your groin and chest area will be shaved and cleansed with an antiseptic solution. Sterile drapes will be placed to cover you from your neck to your feet.
- The procedure is done under general anesthesia and the anesthesiologist will remain at the head of the bed to constantly assess you.
- The doctor will insert a catheter into a large blood vessel (in your groin) and advanced it through the blood vessels to your right atrium. A needle is then used to place the magnetic wire through the septum into the left atrium.
- Another magnetic wire is inserted below the breastbone into the sac of the heart.
- Two magnetic wires find each other and form a bridge over which Lariat suture device is placed over left atrial appendage and the suture is then deployed.
- A TEE is used to assess the position and placement of the LARIAT device.
- The implant procedure could take up to 3-4 hours.
- The doctor will remove the catheters from your groin and chest and apply pressure to the site to prevent bleeding. You will remain on bed rest for 6 hours.
- After your implant, you will be admitted to the hospital. You will be taken to your room and placed on a special monitor, called telemetry. Telemetry consists of a small box connected by wires to your chest with sticky electrode patches. The box causes your heart rhythm to be displayed on several monitors on the nursing unit. The nurses will be able to observe your heart rate and rhythm.
- Before you leave the hospital, we will discuss the results of the procedure with you and your family. We will also tell you when you can resume activities and how often you will need to have follow-up appointments. If you have any other questions, please call our office.
- Avoid vigorous exertion/exercise for 7 days.
- Do not drive for at least 24 hours after your procedure
- You will be give an appointment for follow-up visit and testing.
Regardless of the results of your study and the course of treatment your physician recommends, you play an important role in staying healthy. Be sure to keep all appointments for exams and follow-up tests. Follow your instructions, don’t hesitate to talk about your concerns, and immediately report any new symptoms.
As always, if you have any questions about your health, be sure to ask your physician or call our office at (602) 456 2342