IU Health Bloomington Hospital

Former Greene County Sheriff Relies on WATCHMAN

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October 29, 2019

Gene Gastineau, 83, of Bloomfield, took a nasty fall in 2017, resulting in emergency surgery to address a brain bleed. His situation was complicated by the fact that he was on blood thinners to help control his atrial fibrillation, an irregular and abnormal heart rhythm.

For an active senior who hoped to get back to golfing, the possible health complications from blood thinners was concerning. It was worrisome for his wife, Arlene of 49 years and their five adult children. After a long career in law enforcement, including a stint as Greene County Sheriff, Gastineau was looking to get the most out of his retirement.

Enter Mohan Shenoy, MD, a cardiologist with IU Health Southern Indiana Physicians.

Shenoy had been treating Gastineau for several years for his atrial fibrillation, but at an appointment in 2018 he had a new idea to share. Shenoy’s colleagues Kyle Hornsby, MD and Kevin Zawacki, MD were planning to offer patients an alternative procedure other than the lifelong use of blood thinners.

“I knew that if we could get Gene off blood thinners his risk of head bleed would be drastically reduced,” said Shenoy. “Patients with atrial fibrillation who have had previous major bleeding are at increased risk of bleeding when using blood thinners, and often have to choose between the risks of repeat bleed versus increased risk of stroke. The WATCHMAN device now provides a good option for patients like Gene who face that conundrum.”

Atrial fibrillation can cause blood to pool in an area of the heart called the left atrial appendage, or LAA. There, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.

In people with AFib, not caused by a heart valve problem, more than 90 percent of stroke-causing clots that come from the heart are formed in the LAA. Closing off this part of the heart is an effective way to reduce stroke risk.

The procedure uses a WATCHMAN Implant, which fits right into the patient’s LAA and permanently closes it off to keep blood clots from escaping. WATCHMAN is about the size of a quarter and made from very light and compact materials. It’s a permanent device that doesn’t have to be replaced and can’t be seen outside the body.

The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

On January 30 of this year, Gastineau became the first patient to have the WATCHMAN procedure done at IU Health Bloomington Hospital. Just as planned, he went home the very next day.

“While I was a little apprehensive at first, I trusted my doctors and said, ‘let’s go for it,’ ” said Gastineau.

After the procedure, he had to continue blood thinners for several months until his LAA was permanently closed off. His cardiology team monitored his progress to determine when he could stop the blood thinners.

July 29, 2019 was that day.

"We are very grateful to Mr. Gastineau for placing his trust in our program. We are thrilled that he can now move forward protected from the devastating effects of stroke and free from the bleeding risk of long term anticoagulants," Zawacki says.

Interest in the WATCHMAN procedure is growing. More than 80,000 procedures have been completed worldwide.

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