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Περιγραφή

• addΕνδείξεις

  Despite its proven efficacy, anticoagulation therapy is not well-tolerated or may be difficult to control in many patients. Recently, a device based alternative to the long term use of anticoagulants has been developed and studied.

  In patients with AF, blood tends to pool and form clots in an area of the heart called the left atrial appendage (LAA). If a blood clot breaks loose it may migrate through the blood vessels and cause a stroke. Everyone has an LAA, it is a pouch-like extension located in the upper left chamber of the heart. The LAA is about the size of a thumb and has a narrow opening into the left atrium. Since the majority of blood clots are found in the LAA, by closing it off, it is believed that it may reduce the risk of stroke and potentially eliminate the need for long term anticoagulanttherapy.

  The WATCHMAN LAA Closure Technology is a device alternative to anticoagulant therapy in patients with non-valvular atrial fibrillation. Patients with AF are at a significantly greater risk of having a stroke due to migration of clots that may form in the LAA. By closing off the LAA, the WATCHMAN Technology is designed to reduce the risk of stroke, cardiovascular death and systemic embolisation, potentially eliminating the need for long term anticoagulant therapy. The elimination of anticoagulation may result in a reduction of bleeding related events such as bruising, nose bleeds, gastrointestinal bleeding, or more importantly, haemorrhagic strokes.

• addΠριν τη θεραπεία - Προετοιμασία

  The preoperative assessment will establish if the interventional treatment is the best option for you.

  Tell your doctor yf you’re pregnant.

  Prior to the intervention, your doctor must be prevented about any history of allergic reactions. Blood tests are taken including hemoglobin level, coagulation, renal function, and other specific tests.

  Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. You will be asked to sign a consent form that gives permission to do the procedure.

  Notify your doctor if you are sensitive to or are allergic to any medications, latex, iodine, tape, contrast dyes, and anesthetic agents (local or general).

  Based on your medical condition, your doctor may give you other specific preparation instructions.

• addΜετά τη θεραπεία - Χρόνος αποκατάστασης

  You will be taken back to the recovery area on a trolley and be able to sit up. You will be given pain medication for incisional pain. The nurses will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no untoward effects. They will also look at the skin entry point to make sure there is no bleeding from it. You will generally stay in bed for a few hours, until you have recovered when you will be allowed home.

  Since the procedure is minimally invasive, the postprocedural recovery is usually very fast. The majority of patients can leave the hospital the following day. Indications about recovery and postprocedural treatment will be clearly specified to all patients.

  Anticoagulation with Sintrom and antiagregant treatment with aspirin for a minimum of 45 days following the implant procedure (internal normalized ratio (INR) 2.0-3.0) are recommended. Antibiotic prophylaxis is also recommended when needed. (endocarditis prophylaxis for 6 months following implantation; e.g stomatologic procedures).

  At 45 days, assess the WATCHMAN device placement using TEE. Cessation of anticoagulation is at physician discretion, if the LAA is closed completely and thrombus on the device was ruled out. If flow is noted around the device greater than 5 mm, consideration should be given to keep the patient on Sintrom until it has decreased to less than 5 mm.

  Patients ceasing warfarin should begin clopidogrel 75mg and aspirin daily through 6 months post-implant and continue taking aspirin daily indefinitely.

• addΆλλες πληροφορίες

  Is it painful?

  No, is not a painfull procedure, because it is done under local or general anaesthesia.

  How long does it take?

  The procedure usually lasts about an hour and the patient is typically in the hospital for 24 hours following the procedure.