A simple operation to remove unwanted tissue debris from the heart can prevent stroke in patients with general conditions who need to take anticoagulants, according to a study of about 4,800 people in 27 countries. The lead author of Canada states.
Dr. Richard Whitlock, a cardiac surgeon at Hamilton Health Sciences, said that when blood is pumped from the heart pool of the left atrial appendage, it can form blood clots that block the blood supply to the brain, increasing risk. Said. A potentially fatal stroke. However, Whitlock says removing the appendages of the heart can reduce the risk of patients with atrial fibrillation, which is characterized by arrhythmias, by 33%.
The findings show that rapid surgery, including the removal of appendages, which is almost as useless as the appendix, has changed the practice of 15% of heart surgery patients who suffer from atrial fibrillation and are collecting blood. It suggests that it may be adopted “immediately”. Thinner, Whitlock said.
“This opens up a new paradigm for stroke prevention in atrial fibrillation,” Whitlock said of the results of a McMaster University-led study published in the New England Journal of Medicine on Saturday. American Heart Association.
According to Whitlock, consent patients undergoing heart surgery for other reasons were randomly selected for additional surgery to remove the left atrial appendage, with the result being patients who just took the drug. It was compared.
Anticoagulants that prevent blood clots reduce the risk of stroke by up to 60%. Resection of the appendages further reduces the risk by 33%, and adding these combination therapies greatly benefits patients with atrial fibrillation, which causes 25% of ischemic strokes, Whitlock said. Said to bring.
The study began in 2012 and patients with an average age of 71 years were followed for an average of 3.8 years, he said.
All surgeons involved in the study in 27 countries, including Canada, the United Kingdom, Australia, New Zealand, Germany, Russia, China and Brazil, have been invited to an event hosted by Whitlock on their findings and have changed their guidelines. Will be powerful. He said he was recommended.
“We put a lot of effort into translating knowledge in terms of spreading this benefit, and hopefully surgeons around the world are undergoing cardiac surgery suffering from atrial fibrillation. You can immediately shift the care of your patients and start managing your left atrial appendage. “
Whitlock said it has been suspected that blood clots may form in the left atrial appendage of patients with atrial fibrillation since the late 1940s. But so far, he said, there is no clear evidence to suggest that tissue can be removed to reduce the risk of stroke. He added that some surgeons performed intermittent surgery if they felt that patients who had already had heart surgery were not at high risk.
Patrice Lindsay, who directs changes in the healthcare system of the Canadian Cardiac and Stroke Foundation, said anticoagulants are the gold standard for preventing blood clots and stroke, but the study is a step towards widely adopted procedures in cardiac surgery. He said he would pave the way. Patients with atrial fibrillation.
As with other studies, evidence will be reviewed and consultations with governments and experts will continue on how to put science into clinical practice, said Lindsay, a former cardiac nurse.
“We publish public information to patients and their families to understand what it is, why it is good, and who is eligible,” she said. Changes in the medical system.
“It will take some time, but the process can be done fairly efficiently.”
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