WATCHMAN stroke prevention in Houston

WATCHMAN is a one-time implant that seals off the left atrial appendage, the small pouch where most AFib-related blood clots form. Once the appendage is closed, that clot source is removed. Over about 45 days the body's own tissue grows over the device, and most patients can then stop long-term blood thinners.

Good candidates have non-valvular atrial fibrillation, a stroke-risk (CHA2DS2-VASc) score high enough to warrant anticoagulation, and a reason to avoid long-term blood thinners, such as a history of major bleeding, high bleeding or fall risk, or a careful preference after discussing the trade-offs. Patients with mechanical heart valves or rheumatic mitral stenosis are not candidates.

The implant is done in the EP lab under general anesthesia, through the femoral vein in the groin and across the wall between the heart's upper chambers. It takes about an hour, and most patients go home the same day or the next morning. A short course of blood thinner continues for about 45 days.

That is the goal for most patients. Blood thinners continue for about 45 days while tissue seals the device. At that point a transesophageal echocardiogram confirms the appendage is closed, and most patients transition off long-term anticoagulation. The exact plan depends on how your device looks on that follow-up study.

For the right patient, WATCHMAN offers comparable stroke protection without the daily bleeding risk of long-term anticoagulation. It is most useful for patients who cannot tolerate blood thinners or who have had serious bleeding. For patients who do well on anticoagulation, staying on medication is also reasonable. The decision is individual.