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.
Sharing details on this unique case study, Dr. Ranjan Shetty, Head of the Department, Cardiology, Manipal Hospitals said, “At Manipal Hospitals Bengaluru a 90-year-old gentleman from Central Karnataka presented with 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 he unfortunately developed serious complications. 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.”
He further added, “On one hand, blood thinners are required to prevent clot formation and on the other hand it can cause major bleeding episodes. 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. 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. 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 longevity of the patient.”
Speaking on the occasion, Dr. Anoop Amarnath, HOD Geriatrics, Chief of Clinical Services, Manipal Hospitals said, “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. Infact 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.”