Cardiac Surgeons at the Research Institute for Complex Issues of Cardiovascular Diseases

According to statistics, patients with atrial fibrillation have a five-fold increased risk of stroke compared to patients with normal sinus rhythm. Fibrillatory wall motion and the morphological characteristics of the left atrial appendage (LAA) result in critically slow blood flow, which leads to thrombus formation. A section of a blood clot can break free from the thrombus and circulate in the bloodstream, resulting in stroke. Lifelong anticoagulant therapy (taking blood thinners) is a traditional and widely used method for preventing such complication. However, some patients cannot take anticoagulants due to the high risk of bleeding. Occlusion device implantation in atrial fibrillation patients serves as a great alternative to anticoagulant therapy.

Annually, almost 100 LAA closures are performed in cardiac surgery clinics in Russia. Around 50 successful LAA closures were conducted at the Research Institute for Complex Issues of Cardiovascular Diseases in five years.

Recently, our specialists performed 10 LAA closures. The surgical team included: cardiac surgeons Egor Khomenko and Nikita Bohan, intensivists Oleg Bogdanov and Evgeny Pogorelov, and functional diagnostic specialists Irina Mamchur and Irina Sizova.

- The method is about proper deployment of the occlusion device at the mouth of the LAA. Occlusion device induces a complete cessation of blood flow in the LAA, preventing the formation of the blood clots, - says Egor Khomenko, cardiac surgeon, Ph.D. Technically, the procedure is performed in the following order – first, the femoral vein puncture, then, delivering the occlusion device into the left side of the heart through the atrial septum and lastly, deploying the occlusion device inside the LAA while constantly checking-in with echocardiography and radiography.

The patients were discharged within 5-7 days, but remained under close supervision by the cardiologist. The patients are required to have mandatory health checkups at the Research Institute for Complex Issues of Cardiovascular Diseases for the next six months.

Four more LAA closures are planned to be conducted by the end of 2021.