Potentially life-changing heart procedure performed at Bay hospital
In a medical first for the Eastern Cape, Life St George’s Hospital has launched a new procedure to prevent clotting in the heart caused by an irregular heartbeat, and the strokes which often result.
The first left atrial appendage procedures were carried out successfully on four patients last week and the hospital is now well-positioned to help patients across the province who previously had to travel to Gauteng and the Western Cape.
Interventional cardiologist Dr Warren Muller, 37, said yesterday he was excited to be leading the St George’s team.
“Left atrial appendage procedure is complex but minimally invasive and once completed can be life-changing.
“Patients with an irregular heartbeat are at increased risk of strokes because this condition may allow clots to form in the left atrial appendage section of the heart.
“If a clot travels from the heart to the brain a stroke may occur.”
He said a doctor might prescribe blood thinners and other medication to regulate the heartbeat, but some patients were unable to tolerate this medication.
“In these cases, doctors may recommend a left atrial appendage closure procedure.”
Muller said the burden on stroke sufferers who were forced to take off work and had to spend time in hospital and then more time at home recovering, as well as on the family who had to look after them, was substantial.
“This is a first for St George’s and the Eastern Cape, and as someone who grew up in Gqeberha I’m delighted patients from our province now won’t have to incur the extra costs and stress of travelling down to Johannesburg and Cape Town.”
He said clots generated by an irregular heartbeat typically collected in the left atrial appendage because of its shape — like an ear but sometimes with multiple lobes and bends.
“Where medication was not an option, and since this appendage was not a vital part of the body, the solution was to plug it.
“We use a three-dimensional echo machine to get an initial sense of the size of the left atrial appendage in that particular patient and where the best ‘landing spot’ is going to be to insert the plug.”
Muller said he began the procedure by inserting a catheter in the patient’s right groin and gently navigating it through the blood vessels up and across to the left atrial appendage.
“We guide the crimped-up closure device through the catheter to that landing spot at the entrance of the appendage.”
Using an ultrasound video of one of the procedures last week, Muller explained how once the landing spot had been attained, he studied the situation using a cardiac imaging system, and then released the device.
Shaped like a hat, it unfurled as the catheter was withdrawn.
“The closure device has tiny hooks which grip the sides of the entrance and as it expands to full exposure it completely seals the opening
and that’s where it will remain permanently. The catheter is removed and the procedure is complete.”
He said most patients would be discharged from hospital within 24 hours.
“You will still have an irregular heartbeat but you will be a lower stroke risk.”
He said irregular heartbeat was a common problem, especially among older people, as scarring in the heart created chaotic electrical impulses.
“Symptoms include heart palpitations, shortness of breath, especially with activity, and fatigue during increased activity.”