Is the Watchman safe for a 84 year old man?

Hello all - my brother in law, Craig, fell down a few months ago, and had major internal bleeding. He was on Eliquis. They had trouble stopping his bleeding and because of his fall, they had to take out his spleen and one kidney....He's 84 years old and has a form of Parkinson's as well. He is anemic at times, on a breathing tube on and off (I think it's off sometimes), and sleeps quite a bit (which he was doing before the accident...most likely from his Parkingson's)

Long story short, he is now in Rehab after being in ICU for 3 weeks, and is not doing great. My sister hopes to take him home and take care of him there, but there are a few issues. One is that he has had fainting episodes, which they have attributed to his blood pressure. He was put on BP meds to actually raise his pressure, but he still faints/'falls at times. The Cardiologist came into the rehab today and expressed concern that because Craig isn't on any blood thinners now, and his chance of falling is even greater than it was before, he should get a Watchman. He feels that he is at a high risk of having a stroke right now.

We are concerned that anesthesia may not be good for him, and my sister feels uncertain as to what to do. Have any of you had experience with the Watchman and if so, how big of a deal was it to get it? Any issues afterwards? It seems that it's a bit dangerous no matter which choice is made for him, given his situation and age.

I told her I would pose these questions here as we have such a wealth of information and so many people who have "been in the trenches", so to speak.

This whole topic is unsettling to me as I am also on Eliquis after having a LAA isolation ablation almost 5 years ago....had my 4th TEE last week and although I haven't gotten the official results back yet, the doctor sounded like the numbers weren't good enough to get me off of Eliquis (which was the reason for having the TEE...to see if I could.)

Thank you for any input you can give ~ Barb

Your brother in-law is exactly the sort of patient the Watchman was originally designed for; that is, the patient who can't tolerate anticoagulants but who is at high risk of stroke.

I think you're getting good advice. Although he may have issues with anesthesia, a Watchman implant procedure is very short. Mine took 20 minutes. I think I would go with his doc's advice.

As for you, I think you should consider a Watchman as well. I very much doubt that your TEE results are going to get any better after five years. In fact, I wouldn't bother doing any more of them if I were you.

thanks Carey. We are beginning to wonder if this all makes sense for him though..given his age, poor health overall, and limited if any real progress in rehab. It's a tough decision to make....it would be a big undertaking for everyone, especially Craig - to get him hoisted out of bed, taken to the hospital for testing, then the procedure...and then he has to go on Coumadin or Plavix, doesn't he? Given his tendency to fall now, that doesn't sound like a good thing...

As for me, I am considering it...still scared to do another procedure on my heart...and wondering if it's completely safe or not.

Time for this lady to head to bed..it's been a long day. Thanks for your reply ~ Barb

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thanks Carey. We are beginning to wonder if this all makes sense for him though..given his age, poor health overall, and limited if any real progress in rehab. It's a tough decision to make....it would be a big undertaking for everyone, especially Craig - to get him hoisted out of bed, taken to the hospital for testing, then the procedure...and then he has to go on Coumadin or Plavix, doesn't he? Given his tendency to fall now, that doesn't sound like a good thing...

Yeah, those are some valid concerns.

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As for me, I am considering it...still scared to do another procedure on my heart...and wondering if it's completely safe or not.

It's safe as long as the the person doing the procedure is experienced. I wouldn't be afraid of it if I were you.

Hi Barb,

I’m sorry to hear of your brother-in-laws travails. However as noted above Greg’s scenario, age and complications are not at all unusual in patients referred for Watchman since it originally was designed for folks who can’t tolerate blood thinners.

Keep in mind too, that his cardiologist is seriously concerned about what he or her said is his very significant stroke risk now by doing nothing! Regardless of what ‘might’ occur during a relatively quick and straight-forward Watchman procedure, a serious stroke would surely greatly impact Greg’s life for the worse than any of the other fears you might be thinking of.

All of the many Watchman patients we have followed so far have universally reported experiencing essentially no appreciable recovery period post-Watchman, quite a few even saying they could easily have played tennis the next day. And while tennis is surely off the list for Greg, by the same token, don’t over-project some long drawn out and very difficult recovery from Greg’s Watchman either.

Consider getting a second opinion too if that will help reassure the family and Greg, but be sure to use a Cardio that is very familiar with the Watchman if you do.

And regarding your own concerns about a Watchman for yourself ... remember our early phone calls those now well over 5 years ago prior to your index ablation versus the much easier reality you experienced from your ablation :-). The Watchman install for you Barb will be an even easier contrast!

Best wishes to you and your brother-in-law

Shannon



Edited 1 time(s). Last edit at 04/12/2019 09:02AM by Shannon.

Funny that you read Craig's name as Greg, Shannon, as that is my sister's son. People do get those names confused easily...lol

In my opinion, Craig is mostly treading water at this point, with his daily drowsiness, frequent confusion, very limited mobility, incontinence, etc. One of my other sister's sons said to her, "do you really want to put Craig through all of that?" (with the implied, "for what? So he can go back to living in bed and a chair all day, with next to no quality of life). and that there is the question.....how much to do for someone in a state like that? As one of his nurses said when he was in ICU (for three weeks), "We can do pretty much anything you want. YOU have to tell us your parameters".......It's a hard decision as to where to draw the line....

As for me, I am still waiting to hear back from someone...anyone, after getting my last TEE at Montefiore on April 5th. A doctor came in the room afterwards and made it sound like my "numbers" weren't good enough to get off of Eliquis, but he said the final report wasn't done yet (as of that same day). I am a bit frustrated as I don't know who to ask for the results...and was hoping to get a phone call by now.

How long as the Watchman been out now and have all of the "kinks" been worked out? I know you had a concerning issue, Shannon, but was that from the Lariat?

It is on my radar...just need more info and to talk with either Dr. Natale or someone who can relay info from him.

Best ~ Barb

Hi Barb, My sister’s father-in-law is in his 90s and not in good health. He has had AFIB for many years and had a Watchman procedure a couple of years ago and is doing great. Like Carey said, it is a rather quick procedure and the recovery is minimal. If the doctors don’t think the anesthesia is an issue the stroke prevention seems worth it. However, none of us are there. From your description of his condition I can see where it is a difficult decision. But no one thought my sister’s father-in-law would make it a few years ago, he is still around after the Watchman procedure. I just re-read this and hope I didn’t just confuse the issue... Best to you all.