Home Top

'I'm a woman': Tearful Bruce Jenner reveals he considered suicide while transitioning to his 'true self' in Diane Sawyer interview which will be his last as a man
Inside Bruce Jenner's new life as a woman: Reality star shows Diane Sawyer the little black dress in secret closet of women's clothing and reveals plans for 'glam room'
Kris Jenner DID know about Bruce Jenner's transition attempt during 1980s: Olympian confessed to wife because he could no longer hide his 36B breasts
$LOS ANGELES, CA ñ April 24, 2015: Bruce Jenner ñ The Inverview\nOlympian and reality-TV star Bruce Jenner shares and exclusive and wide-ranging conversation with Diane Sawyer.\nPhotograph:© ABC "Disclaimer: CM does not claim any Copyright or License in the attached material. Any downloading fees charged by CM are for its services only, and do not, nor are they intended to convey to the user any Copyright or License in the material. By publishing this material, The Daily Mail expressly agrees to indemnify and to hold CM harmless from any claims, demands or causes of action arising out of or connected in any way with user's publication of the material."\n$ 'Kim caught me in a dress... and Kendall and Kylie did too': Bruce Jenner reveals his children kept 'family secret' and shares touching story of how Kanye West help wife accept transition
Bruce's second wife tells how he thought about having a sex change in the 1980s
Furious Kris Jenner hits out at Diane Sawyer for claiming she did not provide a comment on Bruce - and insists he is her 'hero'
Husband and wife whose two dogs mauled father-of-three jogger to death as he begged for help could be freed from prison in just 19 MONTHS after reaching plea deal
The summer glow diet: Pioneering book by nutritionist the stars swear by reveals the simple steps to looking and feeling fab
Bruce Jenner reveals he is a Republican Christian who is 'not a fan' of Obama in interview announcing he is transitioning to a woman
Baltimore police admit Freddie Gray should have got medical attention before van ride - but commissioner won't resign over his death
NBC investigators look into Brian Williams interview on the Daily Show about his reporting from Arab Spring protests
University shuts down as hundreds gather in support of Playboy Air Force vet who was arrested for tackling flag tramplers
How being attractive can ruin your career: Good-looking men get less job offers because they intimidate bosses, says study
Now conspiracy theorists say there is a 'hidden army' on Mars: Absurd theory suggests a bunker, people and missiles can be seen on the red planet
Woman, 82, dies after 'sister and nephew failed to move her from her chair for six months'
Woman, 25, gave birth in office bathroom, cut the cord with cuticle scissors, then sealed the baby in a plastic bag... and hid it in her desk drawer
Charles' and Di's 'secret daughter': Wills and Harry have an IVF sister living in hiding according to outlandish story gripping U.S... So is there a single scrap of evidence?
Missouri Senator personal assistant arrested for 'trafficking meth and date rape drugs from China to exchange for sexual favors'
William and Kate's pre-baby shopping spree: Duke and Duchess of Cambridge spotted relaxing with some retail therapy in London before arrival of child number two
Eric Holder waves goodbye to the Justice Department after six years as America's attorney general
District Attorney demands investigation into allegations reserve deputy 'who shot and killed suspect with a gun instead of using his Taser' received preferential treatment from colleagues
The moment a hiker gets the shock of his life when the volcano he is filming erupts before his eyes
The baseball player who could be paid $70m to leave his team: After divorcing Real Housewife and drug relapse, Josh Hamilton risks being dropped by Los Angeles Angels
EXCLUSIVE: Now Ben Affleck's MOM reveals mistakes in documentary that censored star's family's slave-owning past as she says she did NOT take part in Freedom Summer or Freedom Rides

ME AND MY OPERATION: Tiny sieve in the heart to catch killer blood clots

Published: 18:15 EST, 20 April 2015 | Updated: 18:15 EST, 20 April 2015

View
comments

An irregular heartbeat - or atrial fibrillation - raises the risk of stroke. A major new study suggests an implant may be more effective than medication in reducing the risk. Colonel Stanley Rogers, 88, a widower who lives in Brampton, Cumbria, had the procedure, as he tells CAROL DAVIS.

THE PATIENT

Relaxing at home one afternoon, I suddenly felt exhausted. I was dizzy and my heart was racing. I'd had some dizzy episodes before but this was by far the worst, so I immediately went to my GP.

He took my pulse and diagnosed atrial fibrillation, a rapid and irregular heartbeat. I was prescribed digoxin, to slow my heartbeat down, as well as warfarin to thin the blood (with atrial fibrillation the blood can pool in the heart and form clots, which raised my risk of stroke).

Colonel Stanley Rogers, 88, had a procedure to reduce the risk of stroke from an irregular heartbeat

Over the next five years my dizzy spells worsened, even after taking the stronger amiodarone. The problem, which had begun in my heart's upper chambers, had spread to the lower ones. In September 2009, I was admitted to hospital because my heart was racing at 170 beats a minute, instead of the normal 60-100. It was wearing itself out. A few months later I had a pacemaker fitted; I also had an ablation, a procedure to block the abnormal impulses passing into the lower chambers of my heart.

Although these procedures helped to fix the problem in the lower chambers, the upper chambers were still beating too quickly.

The warfarin also caused gastrointestinal bleeds, which made me lose lots of blood. On some occasions I had to be taken to hospital by ambulance and be given a blood transfusion as well as vitamin K to reverse the warfarin's effects. Because of this, doctors swapped me to aspirin but this did not control the bleeding.

In May 2013, I had a stroke. I was in a chair and found I couldn't raise my left hand or move my left leg. My phone was in reach, so I managed to call an ambulance. The weakness was gone in 48 hours but I still needed months of physiotherapy.

After the stroke, I contacted the Atrial Fibrillation Association. It told me about a new procedure where doctors implant a tiny sieve, called a Watchman, in the heart, to catch clots and stop them travelling to the brain.

A device called a Watchman was put in place via a tube in a vein and then expanded in the heart

I told my GP, who referred me to the Freeman Hospital in Newcastle, where I saw cardiologist Dr David Crossland.

He said the Watchman would be put in place via a tube in a vein in my groin and then expanded in the heart, where it would sit in a natural pocket. I had the hour-long procedure in July 2013 under general anaesthetic and woke feeling fine. I went home 48 hours later.

Now I don't need warfarin or aspirin so don't have the bleeds, and the pacemaker controls my symptoms. My only medication now is for blood pressure and the drugs cause me no problems, so I can enjoy being with my two daughters and grandchildren knowing the Watchman protects me from stroke.

THE SPECIALIST

Dr David Crossland is consultant cardiologist at Newcastle's Freeman Hospital.

About a million Britons have atrial fibrillation. it affects 4 per cent of over 65s and nearly 10 per cent of over 75s.

The heart has four chambers; two upper chambers, called atria, and two bottom chambers (ventricles). In a healthy heart, a group of cells in the right atrium called the sinoatrial node (the heart's own pacemaker) sets off an electrical impulse in the upper chambers, making them squeeze blood to the lower chambers for pumping to the body. With atrial fibrillation, other cells can emit abnormal electrical signals, causing the upper chambers to beat in a fast, chaotic manner.

The chambers then don't contract properly, so blood is not pumped through and can pool in a pocket in the atria called the left atrial appendage.

Pooled blood can form blood clots, which can travel to the brain, causing a stroke.

People with atrial fibrillation are five times more likely to have a stroke and this risk rises further in those who also have diabetes, high blood pressure or heart failure, and those over 75.

Doctors use digoxin or beta-blockers to control the heart rate, as well as warfarin or other anticoagulants to thin the blood and stop clots forming.

I can enjoy being with my two daughters and grandchildren knowing the Watchman protects me from stroke

These raise the risk of bleeding, particularly in people with stomach ulcers, or elderly people who are prone to falls, which can cause cuts and lead to blood loss. They also raise the risk of bleeding in the brain - another form of stroke.

We can also try ablation, where we burn scars in the muscle of the left and right atria to block abnormal rhythms so they do not pass to the lower chambers. But this does not stop the risk of stroke, so the patient still takes anticoagulants.

Another option is to plug the left atrial appendage to stop clots there, using a device such as the Watchman.

This was developed in Britain about ten years ago and it is designed to stop clots forming in this pocket.

It looks a bit like a tiny umbrella. It is about he size of a 50p piece and consists of a metal alloy cage covered in a polyester netting. Once in the opening to the left atrial appendage, the cage expands and acts as a filter so clots cannot escape into the body. The body's cells grow into this scaffold, sealing off the left atrial appendage in three months.

The Watchman was developed in Britain and is designed to stop clots forming

Last year a study in the Journal of the American Medical Association said that Watchman was as good as warfarin in preventing stroke, so risk levels return to normal.

As patients can come off warfarin, the risk of bleeding to the brain is also reduced, so the study showed it is more effective than anticoagulants in preventing stroke. Watchman is now being assessed at ten NHS centres across England.

Patients should now be offered warfarin, newer anticoagulants, or Watchman. Warfarin is cheap but the cost of treating bleeding and strokes is high, so Watchman should be cheaper in the long term.

The procedure's risks include bleeding around the heart, which should clear naturally or can be drained. There is also a risk we might not be able to fit it and a small risk of stroke.

First we put a sheath into a vein in the groin, and slide a catheter (a plastic tube) through it to the heart, puncturing the wall between the two atria to reach the left side.

Then we put the catheter inside the left atrium, checking its position on X-ray. We slide the Watchman through the catheter, expanding it in place. Its dangly legs go in first; these have tiny hooks to anchor it in place. The sieve part will then cover the left atrial appendage.

Colonel Rogers's left atrial appendage will now have closed over, lowering his risk of stroke without the need for warfarin.

ANY DRAWBACKS?

Dr Lee Graham, consultant cardiac electrophysiologist at Leeds General Infirmary and Spire Leeds Hospital says: 'The risks are modest, occurring in 3 or 4 per cent of cases, and include bleeding or bruising in the groin, or the device being wrongly positioned or dislodged so it needs removing.

'While anticoagulants are the mainstay of treatment to reduce stroke risk in atrial fibrillation patients, Watchman is a good alternative for patients who cannot take anticoagulants. In future it may also be offered to patients who can.'

The procedure costs between £10,000 and £12,000 privately or £7,500 to the NHS.