New Haven Register (Sunday) (New Haven, CT)
Watchman Procedure is Great Alternative to Blood Thinners in Some Patients
“I’m surprised I’ve made it this far; I’m 75.”
Jim Stewart lives in Rhode Island, but he travels the 90 minutes to St. Vincent’s Medical Center to see their cardiology team quite often. His heart troubles started in 1986, and he’s been seeing Dr. Robert Jumper since 2006.
“He was the best we could find, and I still think he is. And even after all these years, the concern that he shows and the compassion – he has all the things you want in a doctor. He listens.”
What brought Stewart to the Structural Heart Program at St. Vincent’s to begin with? More than 15 years ago, he started experiencing shortness of breath.
“I was still working and running through airports, and I was huffing and puffing,” Stewart said. “I thought I was just getting old.”
Stewart had had a heart attack at age 39, and since then he’s had multiple procedures done on his heart. When other surgeries required him to go off his blood thinners, Stewart then had a small stroke.
“I woke up to use the restroom, my wife said something to me, I was slurring my words, my face was lopsided, and off we went to the ER,” he said. His high risk factors made him a candidate for the “Watchman,” a procedure that has been performed more than 300 times at St. Vincent’s Medical Center.
Dr. Jumper, an interventional cardiologist and the director of the Structural Heart program, says that the Watchman is an alternative for patients who can’t or won’t use blood thinners to protect the body and brain from blood clots. He says the left atrium has an appendage where blood flow slows in everyone. There it can stagnate and clot. The Watchman closes that pouch off, so the blood flows through the heart without going through that area.
“The device looks like a little octopus,” he said. “It has little tentacles which anchor it, and it will close off that hole smoothly with no cracks or crevices. It’s as if you had a street with a big pothole, and the town came in and filled the pothole. Basically, what we are doing is filling that pothole in.”
It’s not an invasive procedure. The doctor makes a small needle poke into a patient’s groin, accesses a vein, and uses that vein to transport the device up to the heart, using just a catheter.
“It’s much better than surgery,” Jumper said. “There is no excision of the chest; it’s efficient, and the recovery is much better.”
While medication is the preferred practice, blood thinners come with many risks: patients must make sure they don’t get an abrasion or contusion where they could bleed because the bleeding won’t stop. Police officers, firefighters, and people who actively exercise or participate in contact sports often shy away from blood thinners because of this. There is also an economic component.
“We have some older patients who are suffering
from the drug prices going out of control, and they’ll be forced to move to different blood thinners,” Dr. Jumper said. “If they’re good on one for years, the insurance will switch, and they’ll be stuck with a $300 copay where they had been paying $20.”
Patients suffering from atrial fibrillation (“afib”) are at particular risk for blood clots. Stewart says a recent bout of COVID-19 left him with exacerbated afib, which is not only uncomfortable, but dangerous.
“It feels funny,” he said. “I used to float in and out of it, but now it’s difficult to walk, breathe, I tire easily; it’s not fun.”
Clotting is more frequent in afib patients because the blood remains
in that left atrial chamber
for much longer, Jumper says.
“When you are in afib, your upper chamber goes from squeezing to just quivering,” he said. “If you were to put your hand out and make a fist over and over again, that would be the heart in a normal rhythm. Everything in the hand would be squeezed out when it shut, so your left atrial appendage gets cleaned out with every heartbeat. But when you are just quivering because you have lost the contraction of the muscle, the blood is stagnating, and that is where you can clot.”
There is a point system to determine who is eligible for the Watchman procedure. Your gender, age, and comorbidities are all taken into consideration. If eligible, patients can
expect to go home the very next day with little to no recovery time needed.
“[Stewart] did well. It was uneventful and smooth, like just about all of our cases,” Dr. Jumper said. “I’ve been able to deploy every device I’ve wanted to deploy, so I’m at 100 percent.”
And it’s not just Dr. Jumper’s experience and expertise that draw the Stewarts back to Connecticut for their medical needs. The way Hartford HealthCare treats patients holistically and considers their whole medical history and lifestyle really helps.
“The people involved in this, the nurses, they walk on water,” Stewart said. “They go out of their way to make it seamless for me. They were ahead of me.
They knew the question before I asked. They could answer any question, and any question they couldn’t answer, Dr. Jumper answered.”
“It’s a team approach, and we take a lot of pride in that,” Dr. Jumper said. “We provide the highest level of service we can.”
This is just one example of Hartford HealthCare St. Vincent’s Medical Center bringing more specialists and providers to the community.
Tune into Hartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions, Thursday, Feb. 24 at noon. And for more information, logon to https://stvincents. org/services/heart-vascular or call 833.444.0014.