The Structural Heart team at Chinese General Hospital and Medical Center (CGHMC) Heart Institute (HI), led by its head, Dr. Timothy Dy announced a successful Left Atrial Appendage Occlusion (LAAO) procedure performed on a patient with Atrial Fibrillation (AF).
The LAAO procedure, performed with the Omega Eclipse device, is recommended for patients who have AF and who are at risk for stroke but cannot take blood thinners or anticoagulation. For most patients with AF, anticoagulation is the recommended stroke prevention treatment.
According to Dr. Dy : “There was only one such procedure done locally before, in 2016, when we had the opportunity to implant the first LAAO device at CGHMC HI. From what I understand, there have not been any such procedures since. So we now have the only two LAAO procedures in the Philippines.”
The patient, an elderly gentlemen with AF, has multiple other problems including slow heart beat requiring prior permanent pacemaker implantation, heart artery blockages for which he has previously undergone angioplasty and stenting. kidney problems, for which he is undergoing long-term hemodialysis, and a history of blockage in a large vein in his chest that required venous stenting. Even though AF requires strong blood thinners to prevent stroke, due to his age and multiple co-morbid conditions, he is considered high bleeding risk (HBR). The desire of the family and the medical team is to mitigate this risk by avoiding long-term anticoagulation.
LAAO was planned with the help of a cardiac CT scan to assess the shape and size of the Left Atrial Appendage (LAA). An intraprocedural transesophageal echocardiogram (TEE) was likewise performed for real time assessment of LAA size and position of the LAAO. Multiple steps of the procedure were guided both by X-ray and echo. After careful evaluation and consideration, a 28mm Omega Eclipse was chosen and successfully deployed into the LAA.
The patient is currently doing well and is benefitting from the device, as he will able to avoid a stroke despite not being on any anticoagulant.
AF continues to be a major cause of stroke. As mentioned, the main stay of treatment is anticoagulation. However, many patients with AF are not candidates for long-term anticoagulation due to high-bleeding risk (HBR) or high-risk for trauma (such as falls). More than 90% of strokes from AF are due to clots in the left atrial appendage (LAA) that are brought by blood flow into the brain. In 2015, the Watchman device became the first U.S. FDA approved device for LAAO. CGHMC’s HI performed the Philippine’s first LAAO with Watchman. Now it performed the country’s second using the Omega Eclipse.
To date, the Heart Institute at Chinese Gen has successfully achieved numerous milestone procedures that have firmly established its expertise in the field of cardiovascular medicine. The team’s remarkable medical achievements have set new benchmarks in heart care, contributing significantly to the advancement of cardiovascular procedures. Among the cutting-edge interventions routinely being performed in CGHMC HI are:
- EVAR – Endovascular Aneurysm Repair: A minimally invasive procedure to address aneurysms in the abdominal aorta, hastening patient recovery and reducing risks compared to open surgery.
- TAVR – Transcatheter Aortic Valve Replacement: An innovative technique for replacing a narrowed aortic valve in patients with aortic stenosis through the groin, offering an alternative for patients who would otherwise need to undergo open-heart surgery.
- TEER – Transcatheter Edge-to-Edge Repair (MitraClip): This less invasive approach is pivotal in treating patients with severe leakage of the mitral valve (regurgitation), enhancing valve function, and patient quality of life.
- TEVAR – Thoracic Endovascular Aortic Repair: A minimally invasive procedure that repairs a dissected or aneurysmal thoracic aorta, decreasing operative risk, shortening hospital stay, improving prognosis and reducing recovery time.
As a leader in medical innovation, the Heart Institute has continued to be at the cutting edge of care for cardiovascular patients needing the most complex and specialized care. These efforts are designed to maximize patient safety and improve clinical outcomes, reflecting our overarching mission to provide “exceptional care within reach.” Our commitment to state-of-the-art cardiovascular treatments ensures that our patients receive the highest international level quality care, closer to home.
For more information, please contact the Heart Institute – Cardiovascular Catheterization and Intervention Unit (Cathlab) at 02 8711-4141 local 291 or 02 8743 1442.
