The senior citizen had a small sac in the muscle wall of his heart’s left atrium, called a left atrial appendage. Untreated blood would collect in the sac, and cause clots in the LAA and atria, forcing doctors to put the patient on blood thinners. This condition also meant that the patient was at risk of a stroke. To avoid these risks, doctors decided to close the sac.

However, the patient had earlier undergone a coronary bypass surgery for blood vessel blocks and had high pressure in the right side of the heart. He also had diabetes, a gastric ulcer and obstructive sleep apnea along with atrial fibrillation (irregular heart rhythm) and a history of a previous minor stroke.

Doctors at Kauvery Hospital in Alwarpet advised an LAA closure procedure. Senior consultant intervention cardiologist Rajaram Anantharaman and clinical lead cardiac electrophysiologist Deep Chandh Raja, led a team that implanted a device, a LAmbre closure device, using intracardiac echo guidance. The patient was discharged on the second day, without being administered blood thinners.

The hospital said intracardiac echocardiography (ICE) is a unique imaging modality that is able to provide high resolution real-time visualisation of cardiac structures and facilitates continuous monitoring of the catheter location within the heart.

Dr. Rajaram said this treatment, closing the LAA with a device, through a blood vessel in the groin, without surgery, was the most appropriate for such high-risk patients. Patients at higher risk for general anaesthesia could also be offered the procedure under local anaesthesia, using intracardiac echo guidance, he said.

Dr. Deep Chandh said the patient was a beneficiary of two techonologies – the LAA closure and the intracardiac echo. According to him, the hospital treats a large number of patients with heart rhythm problems.

Hospital co-founder Aravindan Selvaraj said, “Advancements like intracardiac echocardiography are a boon to treat complex heart conditions, with better precision.”