Left Atrial Appendage Closure (LAAC) Treatment in India

Left Atrial Appendage Closure (LAAC) Treatment in India

A Left Atrial Appendage Closure (LAAC) is a medical procedure used to manage or treat conditions related to Atrial Fibrillation (AFib). It is commonly recommended for patients experiencing Atrial Fibrillation with a high stroke risk and contraindications to long-term oral anticoagulation. This procedure is considered one of the most effective approaches for reducing stroke risk.

Every year, India receives thousands of international patients from countries such as Ethiopia, Nigeria, the UAE, Oman and neighbouring Asian regions for advanced medical care, including Left Atrial Appendage Closure (LAAC) procedures. With experienced specialists for Left Atrial Appendage Closure (LAAC) in India, structured treatment programs and cost-effective medical care, India has become a preferred global destination. India has also emerged as a hub for advanced cardiac interventions, offering excellent Left Atrial Appendage Closure (LAAC) surgery in India options, especially for those needing concomitant cardiac procedures.

India is a major centre for Left Atrial Appendage Closure (LAAC) due to experienced specialists, advanced diagnostics, regulated clinical protocols and cost-effective care pathways.

1. Indications for Left Atrial Appendage Closure (LAAC)

Left Atrial Appendage Closure (LAAC) may be recommended in the following situations:

• Non-valvular atrial fibrillation
• High risk of stroke (CHA2DS2-VASc score ≥2)
• Contraindications to long-term oral anticoagulation (e.g., history of major bleeding)
• Recurrent major bleeding despite oral anticoagulants
• Inability to maintain therapeutic INR levels
• High risk of falls combined with anticoagulation

2. Types of Left Atrial Appendage Closure (LAAC) in India

Percutaneous LAAC (Transcatheter)

This minimally invasive procedure involves deploying a device through a catheter to seal the Left Atrial Appendage. It is typically used for patients who cannot tolerate long-term oral anticoagulation.

Surgical LAAC (Open or Thoracoscopic)

This involves surgically removing or ligating the Left Atrial Appendage. It is often performed concurrently with other cardiac surgeries, such as bypass surgery or valve repair, when open-heart access is already required.

Hybrid LAAC

A combination approach using both minimally invasive surgical and transcatheter techniques. This may be chosen for complex anatomies or specific patient needs, offering a tailored solution.

Advanced or Minimally Invasive Procedures

The predominant and most advanced method for Left Atrial Appendage Closure (LAAC) in India is the percutaneous transcatheter approach. Devices like Watchman, Amulet, and LARIAT are commonly used. These procedures offer quicker recovery and reduced invasiveness compared to traditional surgery.

3. Pre-Treatment Evaluation

Before performing Left Atrial Appendage Closure (LAAC), patients undergo a complete evaluation:

Laboratory Testing

• Complete Blood Count (CBC)
• Kidney/liver function tests
• Coagulation profile (INR, PTT)
• Thyroid function tests (TFT)

Imaging Studies

• Transesophageal Echocardiogram (TEE) to assess LAA anatomy
• Cardiac CT Angiography (CTA) for detailed LAA and surrounding structures
• Chest X-ray
• Electrocardiogram (ECG)

Functional Assessment

• Cardiac evaluation (Echocardiogram, Stress test if needed)
• Pulmonary evaluation (Pulmonary function tests if needed)
• Risk assessment for stroke and bleeding (CHA2DS2-VASc, HAS-BLED scores)

Infection Screening

HIV, HBV, HCV, TB and other infections.

4. Left Atrial Appendage Closure (LAAC) Procedure Overview

The procedure typically includes:

• Pre-operative planning based on imaging studies
• Anesthesia assessment (general anesthesia is common)
• Transesophageal echocardiogram (TEE) guidance during the procedure
• Catheter insertion, usually via the femoral vein
• Transseptal puncture to access the left atrium
• Device deployment within the Left Atrial Appendage
• Confirmation of device position and seal with TEE and fluoroscopy
• Catheter removal and closure of access site
• Transfer to recovery or ICU

The exact steps depend on the type and complexity of Left Atrial Appendage Closure (LAAC).

5. Recovery & Post-Treatment Care

After Left Atrial Appendage Closure (LAAC), patients receive:

• Vital monitoring in a recovery unit, often overnight
• Pain management and anti-inflammatory medication
• Medication protocol, including dual antiplatelet therapy for a few months
• Nutrition and early mobility guidance
• Scheduled follow-up visits, typically at 45 days and 6 months
• Follow-up TEE to confirm device position and assess for leaks

Recovery duration varies, but most patients are discharged within 1-3 days.

6. Risks & Complications

Early Complications

• Pericardial effusion or tamponade
• Procedure-related stroke or transient ischemic attack (TIA)
• Access site bleeding or hematoma
• Device embolization
• Air embolism

Late Complications

• Device-related thrombus (DRT)
• Periprocedural leak (incomplete seal)
• Infection
• Persistent atrial fibrillation (LAAC does not treat AFib itself)

7. Success Rates of Left Atrial Appendage Closure (LAAC) in India

Success rates depend on the severity of Atrial Fibrillation, the complexity of the procedure and the patient’s overall health. Most centres in India report high procedural success.

• 1-year outcome: 95% – 98% device implantation success
• 5-year outcome: Significant reduction in stroke risk, comparable to oral anticoagulants
• Improved functional recovery for most patients by reducing stroke events
• Lower complication rates in high-volume centres performing many LAAC procedures

8. Cost of Left Atrial Appendage Closure (LAAC) in Major Indian Cities (2025)

City-wise cost range for Left Atrial Appendage Closure (LAAC) in India:

• Delhi — ₹8,00,000 – ₹15,00,000
• Mumbai — ₹9,00,000 – ₹16,00,000
• Bangalore — ₹8,50,000 – ₹15,50,000
• Chennai — ₹7,50,000 – ₹14,00,000
• Hyderabad — ₹7,00,000 – ₹13,50,000
• Kolkata — ₹6,50,000 – ₹12,00,000
• Pune — ₹7,00,000 – ₹13,00,000
• Gurgaon — ₹8,50,000 – ₹15,00,000

Costs vary due to procedure type, hospital category and specialist expertise.

9. India vs USA Cost Comparison

10. Condition-Wise Success & Treatment Options

11. India vs Global Cost Comparison (USD)

12. International Patient Services

• Specialist consultations
• Remote medical report review
• Personalized cost estimate
• Medical visa support
• Assistance with accommodation
• Airport transfers
• Interpreter support
• Pre-treatment evaluation coordination
• Post-treatment follow-up planning
• Digital access to medical records

13. Required Documentation

• Identity proof
• Passport (for international patients)
• Medical reports
• Lab results
• Diagnostic images (TEE, CTA scans)
• Treatment consent forms

14. Pre-Treatment Guidelines

• Complete all evaluations including TEE and CTA
• Avoid infections, especially respiratory ones
• Follow medication instructions carefully, especially blood thinners
• Follow fasting guidelines before the procedure
• Disclose all ongoing medications, supplements, and allergies

15. Post-Treatment Guidelines

• Follow prescribed medications, particularly dual antiplatelet therapy
• Attend scheduled follow-ups and repeat TEE scans
• Maintain good hygiene around the access site
• Follow dietary recommendations for heart health
• Avoid strenuous activity, heavy lifting, or prolonged standing until advised
• Monitor for warning signs like chest pain, swelling, or bleeding

16. Why India for Left Atrial Appendage Closure (LAAC)?

• High-volume specialist centres performing numerous LAAC procedures
• Internationally trained interventional cardiologists and cardiac surgeons
• Advanced diagnostics and technology for precise LAA assessment and closure
• Regulated treatment protocols adhering to global standards
• Higher success rates in major centres, reducing stroke risk effectively
• Cost-effective medical care compared to Western countries, without compromising quality

DivinHeal supports international patients in accessing reliable, well-guided and specialist-driven Left Atrial Appendage Closure (LAAC) treatment in India through safe and structured medical pathways.