What should be excluded during a pre-procedural assessment for LAAO?

Excluding the presence of LAA thrombus during a pre-procedural assessment for Left Atrial Appendage Occlusion is crucial because a thrombus in the left atrial appendage can significantly increase the risk of embolic events, such as stroke, during the procedure. The presence of thrombus indicates that blood is not flowing properly in that region, creating a high risk for the dislodgement of the clot during manipulation or occlusion of the appendage.

Identifying and confirming the absence of a thrombus ensures that the procedure can be conducted safely without endangering the patient’s health. If a thrombus is present, it may necessitate prior anticoagulation or a different management strategy before proceeding with the LAAO. This highlights the importance of thorough imaging studies, primarily transesophageal echocardiography (TEE), to visualize the left atrial appendage and assess for any clots before intervention.