Cardiac surgeon Dr. Richard Whitlock of Hamilton Health Sciences is the lead author of an international study that found a simple surgery reduces the risk of stroke after blood clots in patients with an irregular heartbeat. THE CANADIAN PRESS/HO, Hamilton Health Sciences

Cardiac surgeon Dr. Richard Whitlock of Hamilton Health Sciences is the lead author of an international study that found a simple surgery reduces the risk of stroke after blood clots in patients with an irregular heartbeat. THE CANADIAN PRESS/HO, Hamilton Health Sciences

Surgery to prevent strokes in heart patients recommended worldwide: Canadian doctor

A simple surgery to remove a piece of unnecessary tissue in the heart could prevent strokes in patients with a common condition that requires them to take blood thinners

A simple surgery to remove a piece of unnecessary tissue in the heart could prevent strokes in patients with a common condition that requires them to take blood thinners, says the Canadian lead author of a study involving about 4,800 people in 27 countries.

Dr. Richard Whitlock, a cardiac surgeon for Hamilton Health Sciences, said when blood being pumped through the heart pools in the left atrial appendage, it may form a clot that could escape and block the blood supply to the brain and raise the risk of a potentially fatal stroke. But Whitlock says getting rid of that appendage in the heart cuts that risk by 33 per cent for patients with atrial fibrillation, which is characterized by an irregular heart rhythm.

The findings suggest a quick surgery, involving the removal of the appendage that’s about as useless as the appendix, could be adopted around the world “immediately” through a change in practice for 15 per cent of heart surgery patients living with atrial fibrillation and taking blood thinners, Whitlock said.

“This will open a new paradigm for stroke prevention in atrial fibrillation,” Whitlock said of the results of the McMaster University-led study that was published in the New England Journal of Medicine on Saturday, when it was also presented at a conference of the American College of Cardiology.

Whitlock said consenting patients undergoing cardiac surgery for other reasons were randomly selected for an additional operation to remove the left atrial appendage, and their results were compared with those who only took medicine.

Blood thinners, which prevent clots, reduce the risk of stroke by up to 60 per cent. Whitlock said cutting out the appendage shrinks that risk by a further 33 per cent, adding those combined therapies will greatly benefit patients with atrial fibrillation, which is responsible for 25 per cent of ischemic strokes.

The study began in 2012 and patients, with the average age of 71, were followed for a mean period of 3.8 years, he said.

All the surgeons involved in the study across 27 countries — including Canada, the United Kingdom, Australia, New Zealand, Germany, Russia, China and Brazil — are invited to events Whitlock is hosting on the findings, and a change in guidelines will be strongly recommended, he said.

“We will have a significant effort at knowledge translation in terms of getting the word out there of this benefit. And surgeons, hopefully, across the world, can immediately shift practice and start managing the left atrial appendage in these patients undergoing heart surgery, who have atrial fibrillation.”

Whitlock said it’s been suspected since the late 1940s that blood clots can form in the left atrial appendage in patients with atrial fibrillation. Until now, however, he said there wasn’t any definitive evidence to suggest the tissue could be removed to reduce the risk of stroke. Some surgeons have intermittently performed the procedure if they felt a patient already having heart surgery was not at high risk, he added.

Patrice Lindsay, who directs change in health systems for the Heart and Stroke Foundation of Canada, said that while blood thinners have been the gold standard in preventing blood clots and strokes, the study paves the way for the procedure to be widely adopted for heart surgery patients with atrial fibrillation.

As with other studies, the evidence will be reviewed and consultations with governments and experts would follow on ways to move the science into clinical practice, said Lindsay, a former cardiac nurse.

“We would put out public information for patients and families to understand what it’s all about and why it might be a good thing and who would be eligible,” she said, adding development of guidelines and training of surgeons and nurses would also be part of the changes in health-care systems.

“It takes a bit of time, but you can move fairly efficiently through that process.”

Like us on Facebook and follow us on Twitter.

Want to support local journalism? Make a donation here.

Health

Just Posted

Traffic will be diverted through Radium along highways 93 and 95 as a part of the closures. (Claire Palmer photo)
Extended closures to Trans-Canada Highway announced east of Golden this fall

It’s the second round of extended closures as a part of Phase 4 of the Kicking Horse Canyon Project

FILE – Perry Bellegarde, National Chief of the Assembly of First Nations, takes part in an event on Parliament Hill in Ottawa on Tuesday, July 7, 2020. THE CANADIAN PRESS/Sean Kilpatrick
Indigenous Peoples Day must be a ‘call to action’, says Assembly of First Nations chief

Discovery of children at Kamloops residential school site must lead to change, Perry Bellegarde says

This undated file photo provided by Ernie Carswell & Partners shows the home featured in the opening and closing scenes of The Brady Bunch in Los Angeles. Do you know the occupation of Mike Brady, the father in this show about a blended family? (Anthony Barcelo/Ernie Carswell & Partners via AP, File)
QUIZ: A celebration of dad on Father’s Day

How much do you know about famous fathers?

Fruit farmers in the Okanagan and Creston valleys are in desperate need of cherry harvesters amid COVID-19 work shortages. (Photo: Unsplash/Abigail Miller)
‘Desperate’ need for workers at Okanagan cherry farms

Fruit farmers are worried they’ll have to abandon crops due to COVID-19 work shortages

A tent housing a mobile vaccination clinic. (Interior Health/Contributed)
Over 5K jabbed at Interior Health mobile COVID-19 vaccine clinics

The clinics have made stops in more than 40 communities since launching last week

The border crossing into the United States is seen during the COVID-19 pandemic in Lacolle, Que. on February 12, 2021. THE CANADIAN PRESS/Paul Chiasson
VIDEO: Border quarantine to soon lift for fully vaccinated Canadians

Eligible travellers must still take multiple COVID-19 tests

Chilliwack secondary school’s principal is apologizing after a quote equating graduation with the end of slavery in the U.S. was included in the 2020-2021 yearbook. (Screenshot from submitted SnapChat)
B.C. student’s yearbook quote equates grad to end of slavery; principal cites editing error

Black former student ‘disgusted’ as CSS principal apologizes for what is called an editing error

Skeena MLA Ellis Ross. (Photo by Peter Versteege)
BC Liberal leadership candidate condemns ‘senseless violence’ of Okanagan church fires

Skeena MLA Ellis Ross says reconciliation isn’t about revenge for past tragedies

A coroner’s inquest will be taking place at the Capitol Theatre in Port Alberni for the next week. (ELENA RARDON / ALBERNI VALLEY NEWS)
Teen B.C. mom who died following police custody recalled as ‘friend to many’

Police sent Jocelyn George to hospital after intoxication had gone ‘beyond the realm’ of normal detox

FILE - In this Nov. 29, 2020, file photo, Las Vegas Raiders defensive end Carl Nassib leaves the field after an NFL football game against the Atlanta Falcons in Atlanta. Nassib on Monday, June 21, 2021, became the first active NFL player to come out as gay. Nassib announced the news on Instagram, saying he was not doing it for the attention but because “I just think that representation and visibility are so important.” (AP Photo/John Bazemore, File)
Nassib becomes first active NFL player to come out as gay

More than a dozen NFL players have come out as gay after their careers were over

Photograph By MICHAEL POTESTIO.KTW
Former Kamloops security gaurd wants job back after kicking incident caught on video

Rick Eldridge quit when a video surfaced of him kicking a man outside a facility for homeless

Penticton Indian Band Chief Greg Gabriel speaks to the Sacred Hearts Catholic Church burning down early Monday morning, June 21, 2021. (Monique Tamminga Western News)
Penticton band chief condemns suspicious burning of 2 Catholic churches

Both Catholic church fires are deemed suspicious, says RCMP

People participated in a walk to honour the 215 children found at a former Kamloops residential school, as well as residential school survivors. (Twila Amato/Black Press Media)
Kelowna marks National Indigenous Peoples’ Day with walk to remember Kamloops 215

“Let’s speak the truth and deal with the truth, and heal.”

COVID-19 daily cases reported to B.C. public health, seven-day moving average to June 17, 2021. (B.C. Centre for Disease Control)
B.C.’s COVID-19 infections drop to 90 on Sunday, 45 Monday

Pandemic spread dwindles as 77% of adults receive vaccine

Most Read