For patients who are contraindicated, anticoagulants may not be a viable option. Occlusion devices are currently an alternative option.
WATCHMAN Left Atrial Appendage (LAA) Closure Device by Boston Scientific is an FDA approved medical device which closes the appendage, restricting blood flow. Thereby rendering the appendage unable to form a clot reducing the risk of stroke.
There are several other companies in early feasibility of left atrial appendage closure devices such as the Sentre Heart Lariat, AMPLATZER Amulet and AtriCure AtriClip.
The LAA occlusion device space is beginning to overcrowd with similar strategies to solving clot formation inside LAAs. The problem with occluding the LAA is a decrease in heart efficiency. The LAA acts as a compliance chamber, able to stretch and fill when blood pressures are too high. Additionally, stretch receptors in the appendage have been shown to trigger hormone release involved with blood pressure regulation.
Both anti-coagulation medication and LAA occlusion devices have risks opening the engineer’s creative door for a better solution.