What is the recommended duration of anticoagulation therapy after LAAO in most cases?

The recommended duration of anticoagulation therapy after Left Atrial Appendage Occlusion (LAAO) is typically at least 45 days. Following the LAAO procedure, it is crucial to allow time for endothelialization, which is the process through which the blood vessel lining heals and adheres to the implanted device. During this period, patients are still at risk for thromboembolic events, so anticoagulation therapy is necessary to mitigate this risk.

The rationale for a minimum duration of 45 days is based on clinical studies that have demonstrated that this timeframe provides adequate protection while the occlusion device becomes securely integrated into the heart's structure. After this period, the need for continued anticoagulation may be reassessed based on individual patient risk factors for stroke and bleeding, as well as the specific protocols of the healthcare facility.

While some guidelines may indicate other intervals, such as 30 or 60 days, the established minimum of 45 days represents a balance between ensuring safety and allowing for proper healing. The idea of indefinite anticoagulation therapy typically pertains to patients who have not undergone LAAO or those with ongoing atrial fibrillation, rather than a standard post-procedure practice for patients who have had the occlusion performed.