Simple surgery involving removal of left atrial appendage prevents strokes in heart patients

Scientists have shown through a new study that a simple surgery involving removal of left atrial appendage could saves patients with heart arrhythmia from often-lethal strokes.

The study led by McMaster University researchers found that removing the left atrial appendage — an unused, finger-like tissue that can trap blood in the heart chamber and increase the risk of clots — cuts the risk of strokes by more than one-third in patients with atrial fibrillation.

Even better, the reduced clotting risk comes on top of any other benefits conferred by blood-thinner medications patients with this condition are usually prescribed.

Scientists say that their findings will change practice right away because this procedure is simple, quick and safe for the 15 per cent of heart surgery patients who have atrial fibrillation. This will prevent a great burden of suffering due to stroke.

The study results were fast tracked into publication by The New England Journal of Medicine and presented at the American College of Cardiology conference today.

The study tracked 4,811 people in 27 countries who are living with atrial fibrillation and taking blood thinners. Consenting patients undertaking cardiopulmonary bypass surgery were randomly selected for the additional left atrial appendage occlusion surgery; their outcomes compared with those who only took medicine. They were all followed for a median of four years.

Scientists point out that it was suspected since the 1940s that blood clots can form in the left atrial appendage in patients with atrial fibrillation, and it made sense to cut this useless structure off if the heart was exposed for other surgery. This is now proven to be true.

Atrial fibrillation is common in elderly people and is responsible for about 25 per cent of ischemic strokes which are caused when blood clots block arteries supplying parts of the brain. The average age of patients in the study was 71.

The current study tested the procedure during cardiac surgery being undertaken for other reasons, but the procedure can also be done through less invasive methods for patients not having heart surgery.

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