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Health Matters: Providence Mission Hospital | 5 C arole Rice has had just about every kind of heart procedure imaginable: three open heart surgeries, angiograms, stents, ablations and a pacemaker. "I refuse to give up," says the 76-year-old retired Orange County Superior Court clerk from San Clemente. Despite all the cardiac problems she's faced over the past 20-plus years, what scares Rice isn't her heart. It's stroke. "I've seen what strokes can do to people, and I don't want that to happen to me," she says. She takes blood thinners to prevent stroke. However, last year she experienced a condition that caused internal bleeding and needed eight units of blood to replace all she had lost. Providence Mission Hospital cardiologists have found a solution for Rice. In August, she underwent a procedure that should allow her to stop taking blood thinner medication while still minimizing her risk of having a stroke. She was one of the first patients at Providence Mission Hospital to receive the Watchman device. "The Watchman device allows patients with atrial fibrillation to get the same protection they would have on blood thinners without the complications that can occur from those medications," says Sanjay Bhojraj, MD, the interventional cardiologist who performed Rice's procedure. "We have a lot of patients who are at a high risk of stroke but at the same time also at high risk of bleeding complications. The Watchman provides the benefit of protection without the risk of harm." Atrial fibrillation is an irregular heartbeat that prevents the organ from pumping efficiently. In patients with afib, blood can pool in the heart and form clots. Most of these clots are formed in an area called the left atrial appendage. The Watchman is a circular device, about the size of a quarter, that closes off the entrance to the left atrial appendage. For the procedure, Dr. Bhojraj threaded a catheter to Rice's heart and inserted the Watchman device. "It's like an upside- down umbrella that covers the area," he says. Skin cells, he explains, adhere to the Watchman, and heart tissue grows over the implant to form a permanent barrier. "Carole's procedure went extremely smoothly," he reports. Patients receiving the Watchman stay overnight and return home the following day. They start walking about four hours after the procedure, says Dr. Bhojraj. He notes that patients generally remain on blood thinners for about 45 days while the heart tissue forms over the device. Afterwards, they take only baby aspirin. Bringing the Watchman to Providence Mission "shows our vision for providing world- class care in a community hospital," says Dr. Bhojraj. He has launched the hospital's Watchman program along with cardiac electrophysiologist Jay Tiongson, MD. Drs. Lynne Hung and Aseem Desai will also be performing this procedure in the future. Nine days after her Watchman was implanted, Carole Rice reported that she was able to take her first walk around the block with her dog, Seamus. Given all the other procedures she's undergone, she considered this one "a hiccup" and said it went "textbook perfect." She looks forward to eventually returning to Europe with her husband, Jay. They 've visited more than a dozen times. "I am extremely fortunate to live in this era of fantastic medical technology," Rice says. "And Mission Hospital is one of the best hospitals. Not only do I have the very best team of doctors, but the nurses are awesome. They are very professional, caring people who care about you as a person, not just as a patient. "I'm 20-plus years after my first surgery," she adds. "If I can help anyone understand what it means to keep fighting and not give up, I'll do that." To learn more about the Watchman procedure, RSVP for Dr. Bhojraj and Dr. Tiongson's webinar, 12 noon on Dec. 7, at Providence.org/ MissionClasses. Tackling Atrial Fibrillation The Watchman device allows patients to go off blood thinners while minimizing stroke risk. Dr. Sanjay Bhojraj Dr. Jay Tiongson Michael Neveux Photography

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