New technique could reduce risk of stroke after heart surgery

In an effort to reduce the number of patients who suffer strokes after heart surgery, researchers at a Florida medical college have come up with an idea that may dramatically cut back on post-operative strokes.

Their idea? Shift the angle of a device that assists the heart before surgery and doctors may be able to "steer" blood clots away from the brain and toward other parts of the body, where they're likely to do less damage. That's the finding of a study by a team of researchers from the University of Central Florida College of Medicine and Arnold Palmer Hospital for Children.

The change in technique could lower the stroke rate following the implantation of a ventricular assist device (VAD) from 20 percent to 7 percent, said Dr. William M. DeCampli, a professor of surgery at UCF's College of Medicine and chairman of surgery at Arnold Palmer Hospital. VADs manage patients' failing hearts until heart transplants can be performed. VADs help the heart's ventricles pump blood to the body, easing the stress on the organ.

The biggest threat to patients who have VADs is a stroke generally caused by a blood clot that flows from the heart to the brain. By adjusting the way the device is implanted, DeCampli and his team say the blood clots can be redirected toward areas of the body where the potential damage is likely to be less severe. The clots would travel down the aorta, away from the patient's head, instead of traveling up the carotids toward the head. "We just assume the blood clots will form," DeCampli said.

"We're trying to modify blood flow patterns so the clots will not go to the brain." Two of the other researchers, UCF engineering professor Alain Kassab and Daytona State College professor Eduardo Divo used a physics-based computer-simulation procedure -- called computational fluid dynamics -- to develop a model that gave researchers the opportunity to simulate how and where the blood clots would flow. The team's research indicates that the technique could result in even more personalized care for each heart patient.

Patient-specific MRI data could enable doctors to adjust how they implant the VAD's based on individuals specific heart condition. The study was presented this week at the 2010 Annual Clinical Congress of the American College of Surgeons in Washington, D.C. The study was funded by the Orlando Health Foundation.

source: baltimoresun