Brian Le, M.D., of Texas Health Presbyterian Hospital Dallas, is the first in the North Texas region to perform the Lariat, a minimally invasive procedure to prevent strokes in patients with atrial fibrillation.
The Lariat, involves tying off the appendage responsible for 90 percent of strokes in patients with atrial fibrillation, which affects roughly 3 million Americans.
To tie off the left atrial appendage, a tiny incision is made in the patient’s leg vein; a wire is then inserted into the vein, which guides it into the heart. A 3.5 millimeter access in the pericardium guides the wire to the outer atrial appendage. Guide wires with magnets then connect inside and outside the appendage to form a rail. From the pericardium, the Lariat follows the magnetic wire rail to the appendage.
Using X-ray and ultrasound imaging, it is possible to lasso the suture loop over the neck of the appendage and then gently tighten the lasso, cutting it off from circulation inside the heart, eliminating it as a source of blood clots that can travel to the brain.
“This is the best of modern medicine, ”Le said in a statement. “We’re applying technology and advances in patient care to prevent serious problems for a large number of patients.”
Patients with atrial fibrillation who are at high risk for a stroke are advised to take blood thinners for life to reduce the risk of debilitating strokes. But some people with a-fib are not candidates for blood thinners due to concomitant high risk of bleeding on blood thinner. The Lariat procedure fills this void to reduce the risk of a stroke in a-fib without requiring blood thinners.
“Now we have a way to improve the lives of patients who fall into this category through a minimally invasive procedure,” Le said.
Prior to the Lariat, the only way to tie off the appendage was by open heart surgery, he said. After the procedure is performed, patients no longer require blood thinners.