
January 9, 2024
FOND DU LAC – SSM Health Dale Michels Heart & Vascular Care – a collaborative team of specialists offering a full scope of cardiac care – recently hit a pretty significant milestone, completing its 300th WATCHMAN™ procedure.
It’s an accomplishment Cardiologist Tadeo Diaz Balderrama said the team does not take lightly.
“As a group, we identified the importance of having care locally for patients, so patients don’t have to travel a long distance, (as well as) timely care,” he said. “When it comes to cardiovascular disease, time is of the essence… I think it’s important for us as a healthcare system that we acknowledge that and provide services to the patients where they need them.”
What is a WATCHMAN device?
The WATCHMAN device, Balderrama said, is a minimally invasive, implantable device that’s used to block or plug up a specific area in the heart where 90% of strokes originate from in patients who have atrial fibrillation – more specifically atrial fibrillation that is not due to a valve condition.
“Atrial fibrillation is one of the most common rhythm abnormalities in the U.S., and it’s expected to double, I believe, in a matter of 10 years,” he said. “As we age more, we see more patients with atrial fibrillation, and those patients are at an increased risk of stroke – particularly disabling strokes that impact their ability to continue to participate in the workforce.”
Atrial fibrillation, Balderrama said, is also starting to affect a lot of younger patients who are on blood thinners.
“People like firefighters, people like police officers, people who are hunters or who have hobbies that are potentially high risk for injury – I think keeping those patients on a blood thinner may not be optimal for their lifestyle,” he said. “It can be not only cumbersome but dangerous to be on a blood thinner long term.”
The WATCHMAN device implementation procedure, Balderrama said, is minimally invasive and has evolved rather quickly.
“We used to keep patients overnight when the device first came out,” he said. “We are now on the third generation device, about to go to the fourth generation device, and it’s been so easy that people go home the same day.”
Balderrama said in most cases, the procedure takes only 20 minutes.
Once the patient recovers from the anesthesia, he said, they can then go home.
“If somebody is older, traveling a longer distance or it was a little more complex procedure, we usually keep them overnight out of caution,” he said. “But overall, I think the procedure has become so safe that we’re able to do it relatively quickly, safely and with high success rates.”
As of the end of 2023, the heart and vascular care team completed 306 procedures.
Providing ‘big city’ care locally
The completion of the 300th WATCHMAN procedure, Sampoornima Setty, a SSM Health Fond du Lac Regional Clinic interventional cardiologist, said shows the importance of taking care of the community right at home versus them having to travel to larger areas for care.
“The patients, the community that lives in Northern Wisconsin, have traditionally believed in traveling to bigger cities (for speciality care)” she said. “But that was true maybe 25-30 years ago when these services were not available locally… But as time moved on, and the population kept growing in and around the area in Northeast Wisconsin, I think providing the services locally became more and more important.”
Sampoornima Setty
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Keeping the care local is also a benefit to area businesses, Setty said.
“It has become important for the businesses to be able to avail these services locally so their workforce doesn’t have to travel and take more time off,” she said. “And though health care is a service industry, there is some amount of competition we have to face from the major centers regardless, and I think we are in a good position being a smaller center.”
Echoing Setty’s sentiments, Balderrama said most larger systems continue to work under a “hub and spoke” model.
“They have their main hub where their procedures are concentrated, and they have their spoke hospitals,” he said. “You’ll see a lot of micro-hospitals being built around that don’t (have) that expertise locally, but rather work to feed that large hub.”
And, Balderrama said innovation is only good if it’s accessible.
“There’s nothing special about a city that leads to innovation or providing high-quality care,” he said. “They’re able to catch more people… but the reality is, there’s something about providing care in a community you also live in… I think there’s something of value when you provide care for those people that you live with in the community that also pushes you to make sure you’re doing the best job you possibly can.”
Since a lot of innovations within the healthcare industry – such as the WATCHMAN device – are becoming more accessible and straightforward to deliver, Balderrama said “there’s no reason why a (smaller community) center couldn’t provide this type of care,” as long as the center is well organized and has a good support structure.
Which, he said, is the case at SSM Health Dale Michels Heart & Vascular Care.
“I think that’s where our strength is – we work well as a group,” he said. “We acknowledge that this innovation is accessible, and there’s no reason why we need to draw borders with where this is delivered.”
Backed by community
With a healthcare team providing the best care it can to its community, Balderrama said in turn, the Fond du Lac community continues to support them.
The Agnesian HealthCare Foundation has received more than $4.5 million in gifts from the Dale Michels family of Michels Corporation in Brownsville, which Balderrama said has allowed SSM Health Dale Michels Heart & Vascular Care to grow its services.
“It was a grassroots effort that started before SSM was here with the Sisters of St. Agnes,” he said. “None of this was imported into Fond du Lac. This was all because of community desire, and all because of community support. I think the Dale Michels family has been wonderful in supporting and improving cardiovascular care locally.”
The future of cardiovascular care
With the fourth generation of the WATCHMAN device coming soon, Setty said cardiovascular care at SSM Health in Fond du Lac is going to include even more benefits – catheter-based therapy being one of them.
“There are more and more procedures we were only able to offer with open heart previously, now they’re able to offer it with a catheter, minimally invasive, no scar, same-day recovery and patients can go home the same day,” she said. “The fourth generation WATCHMAN will allow us to provide this therapy for patients who have different sizes of atria, so to speak… because we have larger devices available.”
As of right now, with the third generation device, Balderrama said, there is less than a 1% chance of complication with the procedure, with a success rate of 98-99% of all patients – and he said those numbers are expected to get even better with the fourth generation.
Tadeo Diaz Balderrama
Part of that growing success, he said, is making sure the team at SSM Health continues to have a good relationship with the vendors and manufacturers of the WATCHMAN and other cardiovascular care devices.
“(We do that) to make sure we are providing the best evidence-based care for our patients,” he said.
Though Balderrama said the team is proud to be treating cardiovascular diseases to the best of their ability, he said in the future, he hopes to start working more on prevention.
“Maybe we can stop going from treating cardiovascular disease to working a little more to prevent cardiovascular disease, which I think – in my eyes – is the next best investment, right?” he said.
At the end of the day, Balderrama said continuing to provide the best care to the community is what will continue to propel SSM Health’s cardiovascular care forward.
“A community, I think, does a better job in investing in itself, rather than allowing exterior forces to drive that,” he said. “I think we need to continue to do that in health care as well. A community needs to drive that need and say, ‘this is the care we deserve.’ And we need to continue to support that.”
To learn more about SSM Health Dale Michels Heart and Vascular Care, visit ssmhealth.com.