Manipal Hospitals Bangalore stacks up yet another medical marvel to prevent recurrent stroke by using path-breaking technology for the first time in India and South Asia.
Stroke is one of the leading causes of death and disability in India. The primary reason for stroke is atrial fibrillation – a condition where the upper chambers of the heart (atrium) does not contract allowing stagnation of blood, which results in clot formation. This clot can travel to any part of the body and when it blocks the blood supply to the brain, leads to stroke.
At Manipal Hospitals Bengaluru, this 90-year-old male patient from Central Karnataka presented with a history of recurrent stroke and background of atrial fibrillation. Considering his condition, he was placed on blood thinners to reduce the risk of stroke, because of which the patient, unfortunately, developed serious complications. The patient was undergoing bouts of bleeding in the skin as well as urine. “His condition was critical as trivial wounds could lead to bleeding and catastrophic if it occurs in the brain and hence blood thinners had to be stopped completely,” says Dr Ranjan Shetty, HOD and Consultant – Interventional Cardiology, Manipal Hospitals, sharing details on this unique case study.
“On one hand, blood thinners are required to prevent clot formation and on the another hand it can cause major bleeding episodes,” he said adding that here there was a dilemma to treat with blood thinners to prevent stroke especially in a patient who has had more than one episode or to avoid the complications.
Explaining the complicated condition of the patient, Dr Ranjan said; Left atrial appendage is a part of the atrium, which is responsible for the clot formation. A potential method of preventing clot formation would be to seal this area to prevent any clots to spill further.
“However, this was successfully achieved by using a novel and effective device, where the left atrial appendage was closed by using a cardiac occluder. With the appendage sealed off, the blood thinners could be stopped thus reducing the risk of future stroke. The device implantation was a great success and will help in increasing the longevity of the patient,” he added.
According to Dr Anoop Amarnath, HOD Geriatrics, Chief of Clinical Services, Manipal Hospitals, stroke can be a cause for major concern for morbidity and mortality in atrial fibrillation (AF) patients.
“One sixth of the patients with stroke can be traced to have atrial fibrillation. In patients above 80 years, this can be as high as one-third. Ideally, patients with atrial fibrillation will require potent blood thinners to prevent clot formation. In this case, patient was experiencing leakage of blood, which required immediate attention. However, the age of the patient was a matter of concern, but he responded well to the device. In fact, this has improved his quality of life and he is now leading a healthy life without any complications. These devices can be used in the elderly to prevent strokes caused by irregular heartbeats,” says Dr Anoop Amarnath.