Herlev University Hospital, Denmark
Helena Domínguez is graduated in the Facultat de Medicina, Univesitat Autònoma de Barcelona, Spain in 1988. She moved since to Denmark. Helena Domínguez is the Director of Research at the Cardiology department of Herlev University Hospital since 2009 and is the Principal supervisor for several Ph.D. students. During her research, she has received several awards. She has published over 25 papers and has been executive editor of a special issue in Hormone and Metabolic Research in 2008. Helena Domínguez is serving as review editor in several journals and has been graded as top-quality reviewer by Annals of Internal Medicine.
Atrial fi brillation is associated to an increased risk of stroke, mostly due to thrombus formation in the left atrial appendix (LAA). Th erefore, many eff orts are targeted to closing the LAA, which has optimized clinical outcomes. Th e incidence of perioperative atrial fi brillation during open heart surgery is high (35-65% depending on the type of heart surgery), which is considered as a temporary condition if the patients have not received the diagnosis of atrial fi brillation before the operation. We hypothesize that most of the patients who undergo coronary artery bypass, valve repair/replacement or both already have a substrate for atrial fi brillation. Th erefore, closure of the LAA on occasion of open heart surgery will result on a life-long protection from thromboemboli. To test this hypothesis, we randomize subjects who are scheduled to undergo non-emergency CABG, valve repair or both, to surgical closure of LAA in a prospective open blinded-endpoint (PROBE) study. Th e subjects are examined with brain magnetic resonance scans (BMRI) before the operation, at discharge and at least six months aft er discharge. Results are presented as number of white-substance lesions and of cerebral infarcts. Th e primary endpoint is a combination of change in number of lacunar infarctions at the last BMRI compared with BMRI at discharge and of clinical stroke. We perform longterm rhythm monitoring and identify markers for atrial fi brillation by proteomics from biopsies from the right auricle. Th e fi rst 35 patients have completed follow-up. We expect to present preliminary results of the study.