(Vienna, 28 February 2023) For the first time, a surgical left atrial appendage closure has been performed at the department of cardiac surgery of the University Hospital Vienna and MedUni Vienna. In atrial fibrillation, blood clots most frequently form in the small bulge in the left atrium of the heart, which can lead to a stroke. During the minimally-invasive procedure, the left atrial appendage is completely closed endoscopically using a clip. The surgical closure is particularly effective in stroke prevention and reduces the risk of stroke in patients with atrial fibrillation by up to 95%. The taking of blood-thinning medication can also be significantly reduced, or even completely eliminated, after the procedure.
Up to 200,000 people in Austria are affected by atrial fibrillation. With this cardiac arrhythmia, blood clots can form due to the lack of contraction of the small chambers of the heart (atria), thus increasing the stroke risk. In the majority of patients, these blood clots form in the left atrial appendage of the heart. To prevent a stroke, patients with atrial fibrillation are often advised to take long-term blood-thinning medication. However, anti-coagulation increases the risk of bleeding and can cause problems due to interaction with other medication. To reduce the risk of a stroke without drugs, the atrial appendage can be partially closed with a catheter through the groin. During the procedure, the atrial septum of the heart is punctured and a so-called umbrella (also called a ‘watchman’) is inserted from the inside. However, blood-thinning medication generally still needs to continue to be taken.
At the department of cardiac surgery of the University Hospital Vienna and MedUni Vienna, a surgical left atrial appendage closure has been performed for the first time in Austria whereby the left atrial appendage has been completely closed. “Surgical closure of the left atrial appendage is an extremely efficient procedure. A clip is attached to the outside of the left atrial appendage endoscopically, which is particularly gentle on the patient, and allows the atrium appendage to be completely closed. The procedure reduces the risk of stroke in patients with atrial fibrillation by up to 95%. Cardiologically-relevant medication generally no longer needs to be taken after the procedure”, says Günther Laufer, head of the department of cardiac surgery of the University Hospital Vienna and MedUni Vienna.
The minimally-invasive procedure was performed in February 2023 at the department of cardiac surgery on a patient who had been receiving treatment for atrial fibrillation at the (clinical) division of cardiology for some time. The patient had been having to take a high dose of blood-thinning medication for stroke prophylaxis which was increasingly becoming burdensome. The surgical intervention has now eliminated this.
“By means of three small incisions in the armpit and the lower chest area, a so-called ‘atriclip’ was placed around the patient’s left atrial appendage which now completely closes the atrial appendage. Blood clots which cause strokes can no longer form there, and the patient is spared life-long blood-thinning medication”, says surgeon Marek Ehrlich from the department of cardiac surgery. The patient was able to be discharged after only three days, and was then called-in for a follow-up examination with suture removal after two weeks. In a few months, it will be assessed as to whether the minimal dose of blood-thinning medication currently still recommended for the patient can then be discontinued.