Physicians at The Mount Sinai Medical Center are the first in the country to perform a non-surgical procedure using sutures to tie off a left atrial appendage (LAA), which is the source of blood clots leading to stroke in patients with atrial fibrillation (AFib). AFib is the most common sustained heart-rhythm disorder in the United States.
The procedure was performed by Dr. Vivek Y. Reddy and his colleague, Dr. Srinivas R. Dukkipati. With the patient under general anesthesia, the physicians guided two catheters into the patient’s heart to seal the LAA with a pre-tied suture loop. The technique is a safe alternative to drug therapies such as the blood thinner warfarin (Coumadin) that can have serious side effects, as well as open-heart surgery, and more invasive implant surgery.
“People who take Coumadin because of atrial fibrillation include active and otherwise healthy people, as well as elderly people for whom the drug may be contraindicated,” said Dr. Valentin Fuster, director of Mount Sinai Heart.
Drs. Reddy and Dukkipati joined Mount Sinai this month to focus on building the institution’s services for heart-rhythm disorders. They had been performing pre-clinical testing of the non-surgical LAA device, and this procedure represents the first time it's been used on a patient in the United States.
AFib-related deaths have increased over the past two decades and now account for one-quarter of all strokes in the elderly. Those who do take warfarin must rigorously manage the drug’s level in their blood. High levels can cause excessive or internal bleeding, even after minor falls, bruises, or cuts. For some, this management regime can mean monthly tests over the course of many years. In eliminating the need to take warfarin, the LAA procedure can reduce the need for frequent medical visits.
The patient was a 78-year-old woman from Miami who had suffered a stroke and a fall. The hospital says she is recovering well and no longer needs to take the drug for stroke prevention. Patients receiving non-invasive procedures usually return to normal activities in about a week.