Preventing Stroke from Atrial Fibrillation: the LAA Ligation ProcedureSep 24, 2013
Announcer: Medical news and research University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: We're here today talking to Dr. Frederick Han, a Cardiologist at University of Utah Hospital, and we're talking about one of the procedures available for patients who have atrial fibrillation, or AFib, and the procedure we're talking about is called LAA. Dr. Frederick Han, what does that mean?
Dr. Frederick Han: So the LAA stands for left atrial appendage and the procedure itself is call a LAA or appendage ligation. What I like to think about the appendage is I consider it the appendix of the heart in terms that it's a structure that sits off one of the chambers of the heart. It can lead to the formation of blood clots and thus cause a stroke in patients with AFib.
Interviewer: So when you're saying the appendix of the heart basically what you're implying here is that it's an appendage on the heart that we don't really need. It doesn't really serve a purpose.
Dr. Frederick Han: Correct.
Interviewer: So let's talk about patients with atrial fibrillation or irregular heartbeat are at increased risk for stroke. So why would they get this procedure?
Dr. Frederick Han: So we've been performing this procedure in patients who have had AFib and ideally they would be on a blood thinner to prevent or decrease the risk of stroke . . .
Interviewer: Like Coumadin?
Dr. Frederick Han: Like Coumadin. But if they can't take a blood thinner, either because they've had bleeding with the blood thinner, they have an increased risk of falling which would increase the risk of catastrophic events with a blood thinner, or if they've had a previous stroke despite the use of a blood thinner, that these are patients that we recommend this procedure to.
Interviewer: During this procedure you're cutting off this appendage, which is responsible for, you said about 90% of stoke risk in AFib patients?
Dr. Frederick Han: Yeah. It's a suture that we put in from the outside surface of the heart and we put it down to the opening of this appendage. We close off the appendage and, yes, the appendage is typically the source of over 90% of blood clots in patients with AFib.
Interviewer: So by closing it off then you're reducing the risk of stroke in these patients by 90%?
Dr. Frederick Han: That data still remains to be determined but it was the surgical data from what we call the Mays procedures where they close off the appendage has shown a very low risk of stroke, comparable to that of Coumadin in patients with AFib.
Interviewer: So this is one option for patients with AFib at risk for stroke. Is it a safe procedure?
Dr. Frederick Han: Yes, I think for the appropriate patients, this is a very safe procedure. It does involve some new techniques in cardiology but techniques that we're all pretty much familiar with in terms of complex oblation centers like we have here at the University of Utah. And it's one of the approaches that we like to consider as our ways of reducing stroke, as well as bleeding in patients with AFib.
Interviewer: So it's one of the many tools in the tool box we have here for atrial fibrillation.
Dr. Frederick Han: Exactly.
Interviewer: Okay. Thank you.
Announcer: We're your daily dose of science, conversation, medicine. This is the Scope. The University of Utah Health Sciences Radio.