Dr. Nguyen Duc Nghia, from the Department of Thoracic and Vascular Surgery at Tam Anh General Hospital, TP HCM, explained that in patients with atrial fibrillation, the atria do not contract rhythmically but instead quiver. This causes blood to pool in the heart chambers, making it prone to forming blood clots. Ms. Tu's inconsistent use of anticoagulant medication allowed a blood clot to grow. Under the heart's pumping pressure, this clot traveled throughout her body, causing a localized blockage in a narrow blood vessel.

Ms. Tu's right hand was pale due to lack of blood supply. *Photo: Tam Anh General Hospital*

Dr. Nghia stated that if a blood clot travels to the brain, it can cause a stroke. If it travels to the limbs or internal organs, it can lead to arterial blockage. Without timely intervention to restore blood flow, this condition can result in necrosis and become life-threatening.

In Ms. Tu's case, doctors determined the blood clot completely obstructed blood flow to her arm, making balloon angioplasty or stent placement impossible. The optimal solution was surgical removal of the blood clot.

Dr. Nghia (left) and his team performing surgery to remove the blood clot for the patient. *Photo: Tam Anh General Hospital*

Ms. Tu's atrial fibrillation presented challenges during anesthesia. Anesthetics could potentially induce acute cardiac arrhythmia, acute heart failure, myocardial infarction, or even cardiac arrest on the operating table. The medical team closely monitored her heart rate, blood pressure, and blood oxygen levels throughout the procedure.

As an elderly patient, Ms. Tu's blood vessels were less elastic and fragile. Doctors made a small incision in her right arm artery and used a specialized catheter threaded into the vessel lumen. This created pressure to pull the entire blood clot out without damaging the vessel's inner lining. Finally, the vessel lumen was flushed with a specialized anticoagulant solution to prevent new clot formation before the artery was closed.

Immediately after the clot's removal, blood flow was restored to the limb. Post-surgery, her cardiovascular indicators were stable, and she was discharged after two days.

Dr. Nghia advised that individuals with heart rhythm disorders must take their medication consistently and attend regular follow-up appointments.

Patients experiencing sudden pain, numbness, cold limbs, or skin discoloration should seek immediate medical attention for timely diagnosis and treatment.

Bao Anh

* The patient's name has been changed.