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

An SUV sits where it crashed through the front window of the 2:18 Run store in Fairfield Plaza, after the driver appeared to lose control on Monday afternoon. (Photo by Phil Nicholls)
Driver crashes through front window of Victoria running store in Fairfield

Phil Nicholls of 2:18 Run said crash sounded like an earthquake at first

Processed sewage is still being deposited at the Hartland landfill rather than sent as biosolids to a Richmond cement plant. (Black Press Media file photo)
Biosolids at Hartland still being placed on landfill in Saanich

Richmond cement plant up and running, but CRD end product not suitable for purpose

The Greater Victoria Harbour Authority is calling on Transport Canada to rescind its ban to Feb. 28, 2022 on cruise ship stops in Canada, to allow planning to begin in advance of a reopening of the cruise industry next year.
Greater Victoria Harbour Authority seeks end to federal ban on cruise ship stops in Canada

Greater Victoria Harbour Authority CEO hopes cruises will resume by 2022

Seismic upgrading and expansion work at Victoria High School is about a year behind due to pandemic-related factors, the Greater Victoria School District announced. (Photo by Cole Descoteau)
Victoria High School seismic work, expansion a year behind schedule

Greater Victoria School District now targeting September 2023 for reopening of historic school

Elk Lake Drive area resident Michael Blayney protests a proposed multi-building development for his Royal Oak neighbourhood, outside Saanich municipal hall on Monday (June 14). (Photo by Megan Atkins-Baker/News Staff)
Demonstrators protest 11-storey development on Elk Lake Drive in Saanich

Saanich locals gather at municipal hall to protest development, public hearing goes Tuesday

Canadian Prime Minister Justin Trudeau participates in a plenary session at the G7 Summit in Carbis Bay, England on Friday June 11, 2021. THE CANADIAN PRESS/Adrian Wyld
Canada donating 13M surplus COVID-19 vaccine doses to poor countries

Trudeau says the government will pay for 87 million shots to be distributed to poor countries

Montreal Canadiens goaltender Carey Price (31) is scored on by Vegas Golden Knights defenseman Alec Martinez, not pictured, during the second period in Game 1 of an NHL hockey Stanley Cup semifinal playoff series Monday, June 14, 2021, in Las Vegas. (AP Photo/John Locher)
Habs fall 4-1 to Vegas Golden Knights in Game 1 of NHL semifinal series

Match was Montreal’s first game outside of Canada in 2021

Kelowna-Lake Country MLA Norm Letnick, assistant deputy speaker at the B.C. legislature, presides over committee discussions. The legislature is completing its delayed spring session this week, with most MLAs participating by video conference. (Hansard TV)
B.C.’s daily COVID-19 infections dip below 100 over weekend

Only 68 new cases recorded Monday, four additional deaths

A 30x40 ft boat/car shop in the Little River area near Wilkinson Road was fully involved by the time firefighters arrived on scene. Photo by Comox Fire Rescue
Comox firefighters battle ‘showy’ shop fire Saturday night

Smoke could be seen throughout the Comox Valley

Port Hardy council has agreed to cancel Canada Day celebrations in wake of the discovery of the remains of 215 children being found on the grounds of a former residential school. (North Island Gazette file photo)
Port Hardy cancels Canada Day celebrations in wake of Kamloops mass grave site revelation

Coun. Treena Smith made the motion for the chamber to not host Canada Day celebrations this year

Gabriola Island artist Sheila Norgate is promoting the Digital Innovation Group’s art impact survey. (File photo)
Vancouver Island artists get behind regional arts impact study

Artists urged to use their stature to help put arts and culture super-region on the map

Darren Campbell’s truck (pictured) was stolen when he stopped to check on a car in a ditch on Cowichan Bay Road on Monday morning. (Facebook photo)
Vancouver Island Good Samaritan’s truck stolen in nasty trick

‘Try to be a Good Samaritan and my $20,000 truck gets stolen right under my nose’

The Kamloops Indian Residential School is photographed using a drone in Kamloops, B.C., Monday, June, 14, 2021. The remains of 215 children were discovered buried near the former school earlier this month. THE CANADIAN PRESS/Jonathan Hayward
Communities grapple with what to do with former residential and day schools

Some tear them down as a tool to help healing, others repurpose them as tools for moving forward

Creative handmade signs abound at the June 13 Tofino rally for old growth trees. (Nora O’Malley photo)
VIDEO: Tofino stands in solidarity for Fairy Creek Blockades

Over 150 supporters attend rally hosted by Friends of Clayoquot Sound

Most Read