What are the potential clinical implications of leaks following left atrial appendage ligation with the LARIAT device?
The potential clinical implications of leaks following left atrial appendage ligation with the LARIAT device include device-related thrombosis, stroke and systemic embolization, and incomplete surgical ligation of left atrial appendage. Device-related thrombosis is a risk which can be minimized with proper perioperative management of antithrombotic therapy. Stroke and systemic embolization are potential risks associated with incomplete ligation of left atrial appendage. It is important to assess the success of surgical ligation of left atrial appendage with transesophageal echocardiography. Additionally, the North American Thrombosis Forum, AF Action Initiative provides consensus documents which provide guidance on the management of antithrombotic therapy in the perioperative period.  