Good Samaritan Marks 500th Life-Changing Left Atrial Appendage Occlusion Procedure

 

Cardiac electrophysiologists and interventional cardiologists at The St. Francis Heart Center at Good Samaritan University Hospital recently reached a significant milestone by implanting 500 left atrial appendage occlusion devices in patients at high risk for stroke due to atrial fibrillation.

Russell Chen, MD, who performs about 70 Watchman procedures a year, implanted the device in 81-year-old Joseph Guidice of Islip Terrace. Mr. Guidice was the ideal candidate for the Watchman. Diagnosed with diabetes four years ago, Mr. Guidice suffered a fall at his home. While waiting for help, his heart rate rapidly accelerated. At Good Samaritan, he was diagnosed with atrial fibrillation, a condition in which the upper chambers of the heart beat irregularly. This causes blood to pool and form clots in the left atrial appendage (LAA), a small pouch attached to the heart. Those clots can travel to the brain, causing a devastating stroke.

Anticoagulant medications, also known as blood thinners, have been the treatment of choice to prevent stroke in patients like Mr. Guidice, but these drugs can be problematic for many like him who are at high risk of bleeding due to a history of falls or gastrointestinal bleeding. 

The Watchman is a parachute-like device that is implanted in the heart in a minimally invasive procedure. 

“It is a catheter-based procedure,” explained Dr. Chen. “We insert the catheter into the heart through the femoral vein in the groin.”

Echocardiography imaging guides the cardiologist as the Watchman is deployed at the entrance to the LAA. Eventually, skin cells grow over the device, effectively blocking blood from flowing into the LAA.

“For many patients, this is a life-saving procedure,” said Interventional Cardiologist Paul Lee, MD. 

Until recently, the procedure always required general anesthesia to allow doctors to image the heart by placing the echocardiography device in the esophagus. But recently, Dr. Chen and Dr. Lee have been able to insert the intra-cardiac echocardiography (ICE) imaging device directly into the heart through the groin, allowing the procedure to be performed without general anesthesia. 

“We keep the patient awake with sedation, and we can avoid the side effects of general anesthesia and transesophageal echocardiogram,” said Dr. Lee.

Charles Costanzo of West Babylon had a stroke and was later diagnosed with atrial fibrillation which required him to be on blood thinners to avoid the risk of recurrent stroke.

“I’m only 67, but the blood thinners made me feel like I was 97,” he said. 

He describes the Watchman procedure, which Dr. Lee performed in 2023, as life-changing. “I can’t give it enough kudos,” he said. “I was in and out of the hospital, and I’s so happy to not be on blood thinners.”

Mary Heizman couldn’t agree more. The 86-year-old Commack resident was taking blood thinners for about a year to reduce her risk of stroke due to Afib. But the medication caused uncontrollable bleeding. Cardiac electrophysiologist Armen Ovsepian, MD, implanted the Watchman in Mrs. Heizman in November 2022, and she was able to go to dialysis the very next day.

“It changed my whole life,” she said.

Good Samaritan’s accomplished medical staff includes a number of interventional cardiologists and cardiac electrophysiologists who are skilled and experienced in using the Watchman device. They include:

• Paul Lee, MD

• Russell Chen, MD

• Justin Shaber, MD

• Armen Ovsepian, MD

• David Reich, MD