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

Local hiker Kara Ruff captured this double rainbow hiking Ripple Rock near Campbell River on June 15. Photo courtesy Kara Ruff.
Local hiker captures double rainbow

Double rainbow photographed from Ripple Rock trail viewpoint

BC Ferries’ newest Island Class vessel is experiencing an issue with one of its thrusters off the Algerian coast. Photo courtesy patbaywebcam.com.
BC Ferries newest vessel having mechanical issues in Mediterranean

Island 4 will be repaired in Spain before crossing Atlantic

A Photo from Sept. 2020, when First Nations and wild salmon advocates took to the streets in Campbell River to protest against open-pen fish farms in B.C.’s waters. On Dec. 17, federal fisheries minister Bernadette Jordan announced her decision to phase out 19 fish farms from Discovery Islands. Cermaq’s application to extend leases and transfer smolts was denied. (Marc Kitteringham/Campbell River Mirror)
Discovery Island fish farms not allowed to restock

Transfer of 1.5 million juvenile salmon, licence extension denied

People line up to get their COVID-19 vaccine at a vaccination centre, Thursday, June 10, 2021 in Montreal. THE CANADIAN PRESS/Ryan Remiorz
Vaccines, low COVID case counts increase Father’s Day hope, but risk is still there

Expert says people will have to do their own risk calculus before popping in on Papa

The Co-op gas station at Whiskey Creek is burning after a camper van exploded while refueling just before 4 p.m. on Thursday, June 17, 2021. (FACEBOOK PHOTO)
Exploding camper van torches Highway 4 gas station between Qualicum Beach and Port Alberni

Highway traffic blocked after Whiskey Creek gas station erupts into flames

Helen Austin performing with Trent Freeman at the 2018 Vancouver Island MusicFest. Austin is one of the many performers listed for the 2021 event.
Vancouver Island MusicFest goes virtual for 2021

Black Press to stream 25 hours of programming July 9-11

Greater father involvement in the home leads to improved childhood development and increased marital satisfaction, says expert. (Black Press Media file photo)
Vancouver Island researcher finds lack of father involvement a drag on gender equality

Working women still taking on most child and household duties in Canada: UVic professor

FILE – A science class at L.A. Matheson Secondary in Surrey, B.C. on March 12, 2021. (Lauren Collins/Surrey Now Leader)
Teachers’ union wants more COVID transmission data as B.C. prepares for back-to-school

BCTF says that details will be important as province works on plan for September

Provincial health officer Dr. Bonnie Henry outlines B.C.’s COVID-19 restart plan, May 25, 2021, including larger gatherings and a possible easing of mandatory masks on July 1. (B.C. government photo)
B.C. records 120 new COVID-19 cases, second vaccines accelerating

Lower Pfizer deliveries for early July, Moderna shipments up

A Heffley Creek peacock caught not one - but two - lifts on a logging truck this month. (Photo submitted)
Heffley Creek-area peacock hops logging trucks in search of love

Peacock hitched two lifts in the past month

The Calgary skyline is seen on Friday, Sept. 15, 2017. THE CANADIAN PRESS/Jeff McIntosh
2 deaths from COVID-19 Delta variant in Alberta, 1 patient was fully immunized

Kerry Williamson with Alberta Health Services says the patients likely acquired the virus in the hospital

The first suspension bridge is the tallest in Canada, with a second suspension bridge just below it. The two are connected by a trail that’s just over 1 km. (Claire Palmer photo)
PHOTOS: The highest suspension bridges in Canada just opened in B.C.

The Skybridge in Golden allows visitors to take in views standing at 130 and 80 metres

Most Read