Professor Shmuel Banaihead of the invasive cardiology department
The human heart is in a constant state of alternating contractions and relaxations of the heart muscle. The contraction of the atria and ventricles follows a strict sequence, ensuring the movement of blood in the body. If the atria begin to contract irregularly - as it is said, they are fibrillating - then the flow of blood becomes uneven.
This creates conditions for the formation of blood clots inside the left atrium. The clots that arise here can lead to life-threatening complications, such as strokes. Therefore, such patients are prescribed lifelong use of blood-thinning medications (anticoagulants) to prevent clot formation.
However, like most medications, anticoagulants have a number of contraindications. It often happens that patients with atrial fibrillation cannot take these medications. In such cases, the patient is at constant risk of thrombus formation and blockage of vital organs. The brain is most often affected.
A new method of coronary angiography, using watchman technology, which translates from English as “guard,” was developed two years ago in America. Studies have shown that this method of stroke prevention in atrial fibrillation yields results as reliable as the use of blood-thinning medications (anticoagulants).
Prof. Shmuel Banai, head of the coronary angiography department at the Tel Aviv medical center, explains that unlike conventional coronary angiography, used to eliminate blockages in blood vessels and performed through the femoral artery, in this case, the surgeon enters the vascular system through the femoral vein, introducing the latest stent. It is a mesh spiral made of polymer and reinforced on the thinnest tube.
During the coronary angiography, the doctor advances this device from the femoral vein into the right atrium, overcomes the interatrial septum, and finds himself in the left atrium. He needs to place the stent in a section called the left atrial appendage. It is here that blood clots form. In the left atrial appendage, the stent expands, taking on the shape of a mushroom (or an umbrella, whichever you prefer). Now this structure closes and protects the problematic area of the atrium from blood accumulation. Thus, the patient is protected from thrombus formation that threatens his life and is relieved from the need to take anticoagulants for life.
Israel was one of the first in the world to begin using this new technology. The Tel Aviv medical center has already accumulated a certain experience in performing this procedure. The success of the technique and its wide indications for use promise it great popularity. Already now, the coronary angiography department is receiving requests for treatment using this method not only from Israelis but also from abroad. Israeli medicine has always been characterized by increased attention to medical innovations, using every opportunity to improve care for its patients.