A new medical procedure at Texoma Medical Center promises to give a new alternative to some patients at risk for stroke. Earlier this year, the hospital started performing the Watchman procedure, which could remove a reliance on blood thinners for some patients.
“I see this as the future,” said Dr. Maziar Mahjoobi, an interventional cardiologist with Texoma Cardiovascular Care Associates. “There are many people who I feel will opt to not take blood thinners and instead get this procedure done and never have to take blood thinners again.”
Mahjoobi said the procedure is being offered to those suffering from atrial fibrillation, a condition related to heart rhythm that predisposes people to stroke. Specifically, the procedure treats the left atrial appendage, a portion of the heart that seems to have no use but is a prone to forming blood clots.
“It is a remnant in the heart, kind of like the appendix of the gut,” Mahjoobi said. “It really doesn’t have a function, but gives us trouble with atrial fibrillation.”
The procedure involves inserting a small device resembling a mesh net over the left atrial appendage to block it. Over the course of about six weeks, a tissue layer will grow over the device, effectively closing off the appendage and eliminating the risk of developing a blood clot there. The device is inserted through a small incision in the groin and worked through to the heart. Once there, a catheter is used to put it in place. Mahjoobi said most patients are cleared to go home the next day.
Prior to this procedure, the common treatment for this condition was a regimen of blood thinners. While effective, the medication came with its own risks and required some lifestyle changes. The medication also comes with a higher risk of bleeding due to the effects on the patient’s blood.
“For years and years the way we treated this was by putting (patients) on blood thinners so that clot never forms, but that requires being put on medication,” Mahjoobi said. “In some cases you need to watch what you eat, and you have to be very careful that you don’t fall because the risk of bleeding is very high.”
There are some professions where blood thinners could become a liability, Mahjoobi said. Police officers, for example, and other professions with an injury risk are encouraged to not take blood thinners due to the bleeding risk and chance of significant injury.
“(As a police officer) you always have the potential to be shot, so if someone has atrial fibrillation they have to come off the force or off duty because of that,” Mahjoobi said. “This is a great alternative for those people.”
Once the procedure is completed blood thinners are typically needed for about six weeks. During that time, the device still helps reduce the chances of clots.
“At the beginning, it does act somewhat as a filter,” Mahjoobi said. “There is a fiber that goes over this device. Before the skin forms over it, it doesn’t give large clots anywhere to go.”
Mahjoobi noted that the procedure will not be effective for all fibrillation cases. For example, valvular fibrillation (caused by a valve not working properly) would not be helped with this kind of procedure and are “a very small part of the larger atrial fibrillation cases” according to Mahjoobi.