What is a contraindication for LAAO?

A left atrial appendage that is too large or irregular to accommodate a device is indeed a significant contraindication for Left Atrial Appendage Occlusion (LAAO). Successful LAAO depends on the ability to securely place an occlusion device within the appendage. If the anatomy of the appendage is not conducive to device placement—due to size, shape, or significant anatomical irregularities—the procedure may not be effective or safe, potentially leading to complications such as device embolization or incomplete closure of the appendage.

Moreover, understanding the other options helps clarify this context. High blood pressure can be managed and is not considered a direct contraindication for LAAO. A recent myocardial infarction may pose risks in terms of overall stability and safety during any interventional procedure, but it is not an absolute contraindication. Additionally, while a history of a stroke indicates a higher risk for thromboembolic events, it does not inherently prevent someone from undergoing LAAO; rather, it is one of the factors that often leads to the decision to perform the procedure in the first place.

Thus, the anatomical considerations of the left atrial appendage itself take precedence when evaluating the appropriateness of the LAAO technique.