Left Atrial Appendage Closure
Atrial fibrillation (commonly known as “A Fib”) is an irregular heart rhythm that affects more than 3 million people in the U.S. In patients with A Fib, clots can form in a small pouch of the heart called the left atrial appendage (LAA). When these clots break off and go to the brain they cause strokes. Stroke is the main cause of disability or death in patients with A Fib.
For this reason, warfarin (Coumadin), and newer blood thinners like apixaban (Eliquis) or rivaroxaban (Xarelto) are often used to prevent strokes in patients with A Fib.
Although blood thinners are very effective at preventing strokes, they are sometimes not tolerated by patients, for example, due to bleeding from the GI tract, or bleeding in the brain that can happen in patients who fall and hurt themselves. Some research studies suggest that up to 30% of patients on blood thinners stop within 2 years due to bleeding complications.
WHAT IS LEFT ATRIAL APPENDAGE CLOSURE?
To serve a need in patients who cannot tolerate blood thinners, a left atrial appendage closure (LAAC) device called the Watchman device was approved by the FDA to treat patients who were high risk for strokes but cannot take blood thinners long term. It is a small device made of nickel-titanium alloy and polyethylene mesh. This device plugs up the LAA and causes your body to grow scar tissue over the device and wall off the pouch so blood cannot go in and clot cannot come out.
HOW IS LEFT ATRIAL APPENDAGE CLOSURE DONE?
- The procedure is done in the operating room or cardiac catheterization laboratory.
- No incisions are required.
- Patients go to sleep with general anesthesia.
- A small IV tube is inserted in a vein in the leg.
- The Watchman device is inserted into the IV tube and delivered into the heart using a small steerable catheter.
- The Watchman device is released and deployed into the LAA.
- The device stays attached to the LAA.
- The steerable catheter and all IV tubes are removed from the body.
- Most physicians take less than one hour to implant the Watchman device.
- >90% of our patients go home the next day.
WHAT IS THE PATIENT EXPERIENCE WITH THE WATCHMAN DEVICE?
- Worldwide, >60,000 patients have been implanted with the Watchman device.
- Large registries document a 1.7% complication rate for the procedure.
- At MHVI we have being implanting LAAC (Watchman) devices since 2016.
- As of February 2019, MHVI proceduralists have successfully implanted 184 devices.
- At 45 days after implant 98% of MHVI patients with Watchman devices have stopped taking warfarin or other blood thinners.
WHO IS THE WATCHMAN TEAM?
The Watchman team consists of proceduralists (from electrophysiology and interventional cardiology), cardiovascular imaging specialists, advanced practice providers, a nurse coordinator, nurses, technicians, and appointment schedulers.
Jeff Chambers, MD Interventional Cardiologist
Joseph Lin, MD, MPH Cardiac Electrophysiologist
Dali Feng, MD Cardiovascular Imaging Specialist
Sajad Mir, MD Cardiovascular Imaging Specialist
Chad Olinger, DO Cardiovascular Imaging Specialist
For questions regarding LAAC or the Watchman procedure, please contact:
Robin Braun, RN
Watchman/Structural Heart Coordinator