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Heart Disease – Watchman Device – HAS-BLED Score

February 6, 2021
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Transcript

"And the way I think of the Watchman is a little bit different than the average clinician, in that I often think of it as a chess match. We never know who's going to bleed and waiting for people to have a bleed to implant a Watchman is not prudent because when they are bleeding and they're off the blood thinner, it's during that particular period that they are highest risk for stroke. And I've had patients have a stroke just having been off blood thinners for less than a week. So what I look for in my patients is what's their propensity for bleeding. I calculate a score that's widely accepted as assessment for the risk of bleeding over the next year. And it's called the HAS-BLED. And if a patient has a significant HAS-BLED score, I don't necessarily wait for them to bleed to offer them a Watchman. And for those patients that understand that, that are willing to accept the procedural risk from a Watchman, we bring him into the hospital for an overnight state, having gone through their femoral vein and proceeded with delivering a left atrial appendage closure, brand name Watchman, into closed left atrial appendage. And what the Watchman looks like is basically this little device that has these metallic feet that go in and are secured in place in the left atrial appendage attached to a wire. And once we're happy with the deployment, we disconnect and we leave it in place. And over the next few weeks, the body covers this. So that that area is no longer able to receive any blood flow. And if there's no blood going into the left atrial appendage, there's going to be no clot forming in the left atrial appendage. And therefore the risk of stroke is mitigated. And this is a great alternative for those patients that are high risk for bleeding that are not able to take or not willing to take blood thinners indefinitely."

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