Spring 2017

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PATRONS | Spring 2017 13 CLINICAL SPOTLIGHT To learn more about Torrance Memorial's cardiovascular pro- grams, visit www.torrancememorial/cardiovascular_ins tute. CANDIDATES FOR WATCHMAN: • Living with AFib • At high risk for a stroke (level two or higher) • Unable to tolerate blood thinners for a long period of time POSSIBLE SIGNS OF AFIB • Feeling overtired • Pulse is faster than normal or irregular • Shortness of breath • Heart palpitations • Trouble exercising • Chest discomfort • Increased urination • Dizziness, light-headedness, fainting • Asymptomatic Dr. Azam says that while the WATCHMAN procedure has been around for more than a decade, for a majority of that time it was in the clinical trial phase. e procedure is not without risk. e chance of bleeding and further injury exists any time a foreign object is inserted into the heart, according to Dr. Azam. After testing was completed around the world and in the United States, the FDA looked at the data and decided the benefits clearly outweighed the risks and recently approved the procedure. "National trials show as time went on, the operators who perform the procedure became better and better at it, and the risks decreased significantly," says Dr. Azam. Today the success rate is as high as 91% and risk of complications has dropped to less than 4%. In 2016, Torrance Memorial became the first hospital in the South Bay to offer the procedure and one of the few in the greater Los Angeles area. Hancock was Dr. Kim and Dr. Azam's first patient. In the short term, patients who undergo the minimally invasive WATCHMAN procedure can expect to be up and walking within just a few hours and usually go home the next day. In the long term, patients like Hancock can aggressively treat their arthritis and not have to worry about excessive bleeding. How WATCHMAN Works During the WATCHMAN procedure, a plug is mounted on a wire and placed inside a long tube. e tube is then inserted through the patient's vein in the groin area, using ultrasound and X-ray to guide the plug until it reaches the pouch in the left chamber of the heart. Once there, the WATCHMAN device opens like an umbrella and the plug is mounted into the opening of the appendage, sealing it. e position of the plug is then verified through ultrasound to ensure it is stable. Six weeks later, the patient returns for repeat ultrasound study to ensure the plug is still appropriately positioned and no significant blood flow into the pouch is noted. Eventually the tissue of the heart grows over the plug. At that time, the patient can safely take pain medications after discontinuation of the blood thinners. Dr. Azam warns that the patient will still need blood thinners for at least six weeks to ensure no blood clots form at the site of the plug. erefore this procedure is not for someone who cannot tolerate blood thinners at all. "As soon as the procedure was complete and I went back for a recheck, I bought a big bottle of Aleve," Hancock says. She is now happy to be able to better manage her arthritis. She continues, "I wasn't incapacitated in any way. I didn't feel bad from it (the WATCHMAN procedure), no pain. Nothing." Hancock, who arrived in the South Bay in 1966, fell in love with beach living immediately. "I can walk out my door and go down to Knob Hill to see the ocean," she says. Now almost half a year after her WATCHMAN procedure, and more than a year out from back surgery, she hopes to start getting back to more regular exercise and enjoying her physical freedom. "is was the only option for me and it was a fantastic option," she says. Barbara Hancock is looking forward to enjoying more physical freedom now that she is free from blood thinners. PHOTOGRAPHED BY REMY HAYNES

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