Motorcycling Great-grandmother Tackles Stroke Risk With LAAC Implant

6/1/2020

This article originally appeared in Southwest Health & Wellness Magazine – August 2019

On April 4, 2019, Caroline Lackey celebrated her 90th birthday with a cardiac checkup.

Forty-five days earlier, the motorcycling great-grandmother had received a heart implant to help prevent a stroke and eliminate her need for blood-thinners. After taking the medication for a dozen years, the redheaded spitfire suffered from anemia and severe bruising.

“I would wake up in the morning and look like I had been beaten,” said the Englewood resident. “I was taking iron pills and was still anemic. I knew that I could have a stroke very easily. God knows I don’t want a stroke.”

In February 2019, Lackey received the left atrial appendage closure implant in a procedure at Venice Regional Bayfront Health. The device, which is implanted during a minimally invasive surgical procedure, offers an alternative to the lifelong use of blood-thinners for people with a common cause of irregular heartbeat that can lead to stroke.

How Left Atrial Appendage Closure Works

The left atrial appendage closure permanent heart implant device was designed for patients with atrial fibrillation not caused by a heart valve problem (also known as non-valvular atrial fibrillation). Atrial fibrillation, or AFib, affects the heart’s ability to pump blood normally. This can cause blood to pool in an area of the heart called the left atrial appendage, or LAA. There, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.

In people with AFib not caused by a heart valve problem, more than 90 percent of stroke-causing clots that come from the heart are formed in the LAA. Closing off this part of the heart is an effective way to reduce stroke risk.

The left atrial appendage closure implant fits into the LAA. It’s designed to permanently close off the appendage. This will keep blood from flowing into the appendage and prevent blood clots from developing in this area. The left atrial appendage closure implant is about the size of a quarter and is made from very light and compact materials commonly used in many other medical implants. The left atrial appendage closure is implanted into the heart in a one-time procedure. It’s a permanent device that doesn’t have to be replaced and can’t be seen outside the body.

The left atrial appendage closure implant effectively reduces the risk of stroke, without the risk of bleeding that can come with the long-term use of warfarin (the most common blood thinner). The left atrial appendage closure also can eliminate the regular blood tests and food-and-drink restrictions that come with warfarin.

In a clinical trial, nine out of 10 people were able to stop taking warfarin just 45 days after the left atrial appendage closure procedure.

Dilip Mathew, M.D., FACC, FHRS, leads the left atrial appendage closure team at Venice Regional. He and his partner, Antonio Moretta, M.D., FHRS, who also performs the procedure, are board-certified and fellowship-trained in cardiology and cardiac electrophysiology. Their Sarasota-based practice, Heart Rhythm Consultants P.A., focuses on managing heart rhythm disorders.

To implant the left atrial appendage closure, Dr. Mathew makes a small cut in the patient’s groin and inserts a narrow tube, as is done in a standard cardiac catheterization or stent procedure. The surgeon then guides the left atrial appendage closure into the LAA. The procedure is done under general anesthesia and takes about an hour. Patients stay in the hospital overnight and typically leave the next day.

Before receiving the left atrial appendage closure device, patients must meet certain criteria for stroke risk and bleeding risk. Because any medical procedure poses risks, patients should not be considered for Fleft atrial appendage closure if they are doing well and expect to continue doing well on blood thinners.

Lackey doesn’t take blood-thinner medication anymore, although she will take a platelet-reducing drug for a time and will take aspirin the rest of her life.

“There is really nothing to it,” said the great-grandmother about her left atrial appendage closure surgery. “The nurses and doctors (at Venice Regional) are fantastic, and I went home the next day.”

For information about AFib and the left atrial appendage closure procedure, call (941) 486-6790.

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