Watchman Device Bring Life-Altering Change

McLaren Health Care, McLaren Northern Michigan
Ray ThompsonContributed by: Steve Foley, Petoskey News Review

Former U.S. Navy pilot Ray Thompson and his wife, Rose, have traveled across the world.

Thompson, a project advisor who lives on Maple River Road in Brutus, estimates the two have completed more than a dozen trips to Alaska and the Yukon, been north of the Arctic Circle three times, the Arctic Ocean once, Newfoundland and Labrador four times.

“Canada is impossible to work with as far as medical stuff is concerned,” said Thompson, who for years was on Warfarin, a blood thinner, following open heart surgery in 1996. “Appointments aren’t there and money has to be there up front. At least every two to three weeks, I had to be back in the states.

“It’s hard to be back in the states if you’re up in the Arctic Ocean,” Thompson said. “Now, I don’t have to mess with that. It was really a problem.”

The 83-year-old Thompson who had been taking Warfarin for 17 years is no longer on blood thinners as a result of a recent operation performed at McLaren Northern Michigan known as Watchman.

In February, the McLaren Northern Michigan Heart and Vascular Center team of Dr. Jason Ricci, interventional cardiologist; Dr. Daniel Buerkel, electrophysiologist; and Dr. Naomi Overton, electrophysiologist, began performing Watchman — a left atrial appendage closure device — which allows patients like Thompson to stay close to home rather than traveling elsewhere for treatment.

It’s also has let Thompson resume his traveling, and not having to worry about medication issues when in Canada.

“It’s enabled me to maintain a standard I’m really pleased with,” Thompson said. “Some time ago, I told my doctor I’ve established a lifestyle over a number of years. Medicate me so I can maintain it. I think they’ve done a fabulous job.”

The Watchman is an FDA-approved alternative to blood thinning medicines for patients like Thompson with atrial fibrillation, a condition which affects an estimated 3 million Americans. The Watchman reduces the risk of atrial fibrillation-related stroke for patients who are considered poor candidates for long-term anti-coagulants.

“I think blood thinners work well. The issue with blood thinners is when you look at a large sample or data base only about 60 percent of patients who are on blood thinners are at the right dose,” Ricci said. “That’s because they’re either having issues with bleeding, they don’t want to take them or there’s compliance issues.

Ricci said the problem with atrial fibrillation is it’s really prevalent.

“The stat I always give is 25-27 percent of men over the age of 70 will develop it, and 23 percent of women,” Ricci added. “So you have a very prevalent condition in AFib, it causes strokes, anywhere from 5-10 percent per year are at risk of stroke and the strokes tend to be devastating because the clots that form tend to be big clots and cause big strokes.

“You have a very prevalent problem with a devastating consequence with a good therapy in blood thinners, but only 60 percent of people are on them,” Ricci said. “That’s where the Watchman comes in. There’s a huge unmet need.”

Ricci said the procedure, which was FDA approved in 2015, is proven to be effective and safe.

A minimally invasive procedure, the Watchman — which looks like a jellyfish or parachute device around the size of a quarter — is entered through the femoral vein in the leg.

“It’s a needle puncture which leads into the right atrium,” Ricci said. “Once we get in there, we cross over into the left atrium where 90 percent of the strokes form at the left atrial appendage.”

After the device, which comes in five different sizes which fit nearly 97 percent of patients, is implanted, healthy heart tissue grows over the mesh over a six-week period which seals the appendage, Ricci said.

“The procedure itself is done under general anesthesia, it takes about an hour,” Ricci said. “Afterward people go home the next day, they have a stitch in their leg we cut out about four hours later and the patient can resume their normal activity in two days.”

Ricci said the Watchman is shown to be as effective as Coumadin, or blood thinners, in preventing strokes.

“I tell people it’s not better than blood thinners, but it’s equivalent to blood thinners which is attractive to people who can’t or won’t take blood thinners,” Ricci said. “It’s certainly far superior to doing nothing. For people who aren’t on blood thinners, it reduces the risk of stroke by 80 percent.”

Once the Watchman is in place, patients benefit from not needing blood thinners. National studies have shown 92 percent of patients are off of anti-coagulant medication six weeks post Watchman, while 99 percent of patients are off them after one year.

“Typically, after the device is put in they’ll be on a blood thinner for six weeks to prevent clots from forming on the umbrella,” Ricci said. “We bring them back, perform a TEE (transesophageal echocardiography) which gives us an image of the appendage to make sure it’s sealed and there’s no leaks and we pull them off Coumadin. They’re then on aspirin and Plavix, which is like a super-charged aspirin, for six months and then on baby aspirin indefinitely.”

Thompson checked back with Ricci about four weeks following his procedure earlier this year and said he’s been as happy as a clam since.

“I’m off Warfarin. They took me off aspirin and I’m just on baby aspirin,” Thompson said. “It was a piece of cake, particularly after having open heart surgery which was like getting hit by a bus.

“The best part of it is they’ve tracked the whole process all the way through,” Thompson added. “They’ve (McLaren) really paid close attention and we’ve had a good relationship.”