A pair of Indian-origin physicians at The Mount Sinai Medical Center become the first doctors in America to perform a non-surgical procedure using sutures to tie off a left atrial appendage (LAA), the source of blood clots leading to stroke in patients with atrial fibrillation (AFib).
Dr. Vivek Y. Reddy, Professor of Medicine and Director of the Cardiac Arrhythmia Service at Mount Sinai Heart, and his colleague Dr. Srinivas R. Dukkipati, Director of Mount Sinai's Experimental Electrophysiology Laboratory, performed the procedure on Wednesday.
With the patient under general anaesthesia, the physicians guided two catheters into the patient's heart to seal the LAA with a pre-tied suture loop.
The doctors have revealed that the procedure is a safe alternative to drug therapies like the blood thinner warfarin (Coumadin) that can have serious side effects, as well as open-heart surgery, and more invasive implant surgery.
"People who take Coumadin because of atrial fibrillation include active and otherwise healthy people, as well as elderly people for whom the drug may be contraindicated," said Dr. Valentin Fuster, Director of Mount Sinai Heart and Chair of the American/European Guidelines of Atrial Fibrillation.
Drs. Reddy and Dukkipati, who joined Mount Sinai this month to focus on building the institution's services for heart-rhythm disorders, had been performing pre-clinical testing of the non-surgical LAA device, and this procedure represents its first application in people in the US.
"We are very proud of the recruitment of Dr. Reddy and his exceptionally talented team. Their pioneering work has the potential to redirect the field of cardiac rhythm disorders," said Wayne Keathley, President and Chief Operating Officer of The Mount Sinai Hospital.
"Compared to a lifetime of medication therapy, or other surgical modalities, a one-time, non-surgical procedure to relieve the complications of AFib offers a whole new paradigm. Drs. Reddy and Dukkipati have ushered in a new standard of care for people with this serious cardiac condition," said Dr. Dennis S. Charney, Anne and Joel Ehrenkranz Dean, Mount Sinai School of Medicine, and Executive Vice President for Academic Affairs, The Mount Sinai Medical Center.
The patient, a 78-year-old woman from Miami, presented with a history of stroke and a fall.
Her physicians prescribed Coumadin but had difficulty titrating the medication for her. She initially sought an implant, but travelled to Mount Sinai for the non-surgical, catheter-based suture delivery system.
After the procedure, she is recovering safely and no longer needs to take the drug for stroke prevention. Patients receiving non-invasive procedures usually return to normal activities in about a week.
The procedure-aided by the LARIAT Suture Delivery Device, which was developed by SentreHEART, Inc., and approved by the FDA in May-was performed in a cardiac catheterization laboratory, and did not require cardiopulmonary bypass.