Longview Regional Medical Center first to offer new stroke prevention procedure
by Joycelyne Fadojutimi
Longview Regional Medical Center(LRMC)in east Texas is the first and currently the only local medical facility to provide the revolutionary new non-valvular atrial fibrillation (AFIB) as an alternative to the older stroke treatment of anticoagulants (blood thinners) with a Left Atrial Appendage Closure (LAAC) Implant. Dr. Jorge Massare works at LRMC as a cardiac electrophysiologist. He is the first to perform the operation in East Texas.
“This is a life-changing procedure for some patients with Atrial Fibrillation that requires an alternative to long-term blood thinner medications,” he said.
The device is so far, the only FDA-approved implant that extensive clinical trials have proven effective in reducing stroke and clot risk in AFIB patients. Used successfully in more than 50,000 patients worldwide, the implant closes an area of the heart known as the left atrial appendage (LAA.) This is identified as the source of most stroke-causing blood clots.
AFIB joins a long list of previously developed minimally invasive cardiovascular techniques already used by LRMC. Some of the hospital’s board-certified cardiologists helped pioneer such procedures as coronary and peripheral interventions, trans-cutaneous aortic valvular replacements (TAVR,) aortic aneurysm endovascular repairs (AAA repair,) cartoid artery stenting, complex arrhythmia ablations, implantations of pacemakers and defibrillators (including the latest leadless miniature pacemakers,) and laser lead extractions.
AFIB is only about the size of a quarter and is shaped like an umbrella. The surgeon uses a catheter to introduce the device through a small incision in the patient’s groin (Fenoral Vein,) and from there to the heart. The implant is then expanded and released in such a position that it seals off the LAA. This prevents the formation of clots that might otherwise migrate to the brain and other parts of the body. Normal heart tissue eventually grows over and covers the implant, enabling the patient to discontinue blood thinners except for aspirin.
The complete procedure only takes about an hour and does not include open surgery. Patients usually go home the following day and are temporarily prescribed Warfarin “Coumadin.” Candidates for the implant suffer from AFIB and at least one of the following conditions:
* Gastrointestinal bleeding
* Previous brain bleeding
* Easy bruising
* Frequent falls or increased fall risk
* High-risk occupations to take blood thinners
* Appropriate rationale to not take anticoagulants on a long-term basis
This procedure could be life-saving in some patients according to Dr. Massare. “Giving long-term blood thinners, can be risky in some patients, especially as they age, and this is exactly the population to who AFIB becomes more prevalent.” He then added, “Even if a patient is deemed not a candidate for the procedure, the extensive conversation with them becomes a great opportunity to educate about AFIB and overall cardiovascular health and care.”