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

Black Press file photo
RCMP seek suspect in Vancouver Island-wide crime spree

Crimes stretched from Deep Bay to Qualicum, Ladysmith, Chemainus and Youbou

North Cowichan’s committee of the whole have rejected staff’s recommendation to limit the use of fireworks to Halloween. (File photo)
North Cowichan rejects limiting fireworks to Halloween

Municipality decides staff recommendation would be unpopular

Things are looking up for Vancouver Island as zero COVID-19 cases have been reported for the first time since October. THE CANADIAN PRESS/Darryl Dyck
Island records zero new COVID-19 cases for the first time since October

For the first time since October, the province is reporting zero new… Continue reading

CVRD Area E director Alison Nicholson, right, hiked two hours to Waterfall Camp at the Fairy Creek watershed along with Comox town councillor Nicole Minion and Comox Valley Regional District director Daniel Arbour to meet with old-growth logging activists on Monday, June 7. (Submitted)
Cowichan Valley regional director visits Fairy Creek protest camps

‘They clearly communicated that they are committed to what they are doing’

A small pod of Pacific white-sided dolphins pass by close to shore in Campbell River June 16, 2021. Still capture from video courtesy of Kimberly Hart
VIDEO: Dolphin sunset captured from Vancouver Island shore

Spectacular setting for view of travelling pod of Pacific white-sided dolphins

Karl and Stephanie Ann Johanson were thrilled to spot a pair of Sandhill Cranes in the Panama Flats this month, an unusual appearance for such birds. (Photo by Stephanie Ann Johanson)
WATCH: Sandhill cranes an unusual, joyful sight in South Island parkland

These birds don’t often touch down on their way between northern B.C. and Mexico

(V.I. Trail/Google Maps)
Now 90% complete, Vancouver Island trail forges new funding parnership

Victoria Foundation takes on Vancouver Island Trail Association; fund valued at $40,000

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Police are asking for public assistance in locating Anthony Graham who has been charged with the murders of Kamloops brothers Carlo and Erick Fryer. (RCMP photo)
2 charged, suspect at large in killings of B.C. brothers linked to gang activity: RCMP

Kamloops brothers Erick and Carlo Fryer were found deceased in May on a remote Okanagan road

Albert Health Minister Tyler Shandro and Alberta Premier Jason Kenney unveil an opening sign after speaking about the Open for Summer Plan and next steps in the COVID-19 vaccine rollout, in Edmonton, Friday, June 18, 2021. THE CANADIAN PRESS/Jason Franson
Alberta 1st province in Canada to lift all COVID-19 public health restrictions

70.2% of eligible citizens 12 and older in the province have received a dose of the vaccine

Fraser Health registered nurse Ramn Manan draws a dose of the Pfizer COVID-19 vaccine into a syringe at a walk-up vaccination clinic at Bear Creek Park, in Surrey, B.C., on Monday, May 17, 2021. THE CANADIAN PRESS/Darryl Dyck
‘Honour our fathers’ with COVID-19 vaccine protection, B.C. urges

109 new cases Friday, 75 per cent of 12 and up immunized

Freighters have becomd abundant in the Trincomali Channel on the east side of Thetis Island.
Nanaimo ponders taking on waste from nearby anchored freighters

Vancouver-based Tymac petitioning the Regional District of Nanaimo to accept waste at its landfill

(Paul Henderson/ Chilliwack Progress)
Trutch Avenue in Chilliwack to be renamed to remove racist taint

New name to have Indigenous significance as Chilliwack takes new step toward reconciliation

Most Read