Structural Heart Program at Providence
Every person's body is a little bit different. When the differences are in the structure of your heart, they can be dangerous.
Is the structure of YOUR heart a concern?
Structural heart conditions, which stem from physical variation in the organ, are common. Symptoms of heart abnormalities vary widely depending on the area and degree of variation. For many of these conditions, however, treatment involves a minimally-invasive, quick recovery procedure that is fully covered by insurance and that vastly improves the length and quality of life.
Unfortunately, less than half of all patients that meet the criteria for structural heart disease treatment ever get an evaluation.
"Almost everyone knows someone with a heart murmur or an issue with a valve in their heart. The ones that are known and being properly monitored are less concerning to me," says Providence Heart Cardiologist Garrison Morgan, MD. "It's the ones that remain undetected or untreated that concern me because they are not being managed by a heart specialist and may need to be."
- Click here to see the reunion of Dr. Morgan and the first MitraClip patient in the Midlands one week after her procedure.
Structural Heart conditions include:
- Aortic stenosis
- Atrial Fibrillation (A-Fib)/ Stroke
- Atrial septal defect (ASD) / Patent foramen ovale (PFO)
- Ventricular Septal Defects (VSD)
- Hypertrophic cardiomyopathy (HCM)
- Mitral regurgitation
- Mitral stenosis
- Pulmonary stenosis
- Surgical Valve Leaks
Procedures to treat Structural Heart conditions include:
This surgical alternative for select patients with severe symptomatic aortic stenosis is a minimally invasive procedure that places a new stent-based valve inside of the diseased valve. TAVR avoids the need for more invasive surgical procedures such as sternotomy and cardio-pulmonary bypass by performing the procedure through a small hole made in a vessel in the patients leg. It is more successful than more conservative treatments, and in select patients it has as good or better outcomes than surgical valve replacement. TAVR patients also enjoy a shorter hospital stay than heart surgery patients, and people who are advanced in age or have coexisting conditions are still good candidates to have this procedure performed.
Valve in Valve Trans-catheter Valve Replacement (Aortic or Mitral)
This is an alternative for patients who already have a surgical bio-prosthetic aortic or mitral valve that is deteriorating or has already failed. This minimally invasive procedure uses a catheter to place a new TAVR valve inside of the old surgical prosthetic valve, avoiding the need for repeat open heart surgery and its associated risks by performing the procedure through a small hole made in a vessel in the patients leg. People who are advanced in age or have coexisting conditions are still good candidates to have this procedure performed.
Trans-catheter Mitral Valve Repair with the MitraClip® Device
This is a minimally-invasive surgical alternative for select patients with moderate (or greater) mitral regurgitation (a leaky mitral valve). In this procedure, a catheter places a device over the source of the mitral valve leak, clipping the valve's leaflets together to eliminate the leak. Patients can use this option in place of the more disruptive sternotomy or cardio-pulmonary bypass surgeries by performing the procedure through a small hole made in a vessel in the patients leg. Those who have the MitraClip, report an increased quality of life and experience a significant reduction in hospital re-admissions for symptoms of heart failure. People who are advanced in age or have coexisting conditions are still able to have this procedure performed. This is a good option for people with advanced congestive heart failure, right heart failure, pulmonary hypertension or atrial fibrillation with moderate to severe mitral regurgitation.
Left Atrial Appendage Occlusion (WATCHMAN™ Device)
Blood-thinner medications are commonly prescribed for people with atrial fibrillation due their increased risk of stroke. However, a significant segment of the population has difficulty with these anti-coagulation medicines due to the increased risk of bleeding. The WATCHMAN device is an alternative therapy for these patients. This minimally invasive procedure places a self-expanding wire mesh device in the left atrial appendage, which essentially closes off the area where the majority of stroke-causing blood clots form in A-fib patients. The device reduces the risk of all strokes just as much as the medication, including a 85% reduction of hemorrhagic stroke incidence. The WATCHMAN device involves a single implant procedure compared to the lifetime cost of daily anti-coagulation meds, testing, and bleeding complications.
Atrial Septal Defect (ASD) / Patent Foramen Ovale (PFO) Closure
Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO) are the names of two different types of holes in the tissue between the heart's two upper chambers. During fetal development, there is an intentional hole called the foramen ovale in the wall between the left and right atria that allows blood to bypass the developing lungs, which do not work until birth, when the lungs are exposed to air. In the case of ASD, the septal tissue fails to form during fetal development. In the case of PFO, the foramen ovale fails to close after birth, which it normally does within a few months. Both of these conditions can be treated with a minimally invasive procedure that implants a wire mesh disc on each side of the atrial septum to patch the hole between the top chambers of the heart.
This is an especially good solution for patients who have an enlarged right atrium / right ventricle, who show evidence of right heart failure, or who have pulmonary hypertension. This is also a good solution for patients who have experienced a stroke of unknown origin, which may have passed through the hole in the heart.
Prosthetic Valvular Leak Repair/Plug
A paravalvular or paraprosthetic leak is a rare complication of surgically implanted prosthetic heart valves in which the patient experiences a leak between the prosthetic valve and the cardiac tissue. This leak can be patched with a wire mesh device, applied through a minimally invasive procedure, that plugs the space between the valve and the tissue. This option allows the patient to avoid repeat surgery to fix paravalvular holes that can lead to heart failure.
Aortic Balloon Valvuloplasty and Mitral Balloon Valvuloplasty
Sometimes a person's heart valve is simply too narrow for the heart to function properly. When this condition occurs between the left ventricle and Aorta, it is called aortic valve stenosis. When this occurs between the left atrium and the left ventricle, it is called mitral valve stenosis. Both can be treated with a minimally invasive procedure that uses a catheter-directed balloon to widen the valve opening. Often these procedures are used as a "bridge" until a person can receive surgical valve replacement or a TAVR Valve, such as women who shows signs of stenosis during pregnancy or individuals who are currently too weak or ill to have a more invasive procedure, but who are expected to improve with time if given this procedure.
Early Detection of structural heart conditions saves lives.
All of the procedures lited above are currently available with the Structural Heart Program at Providence. This program provides you with a team of interventional cardiologists and cardiothoracic surgeons who work collaboratively to diagnose and treat conditions related to the heart's structure. This personalized, coordinated care from a wide field of experts gives you access to a full slate of medical, surgical, and minimally-invasive treatments, from a health system nationally-recognized for quality cardiac care.
Less than half of all patients that meet the criteria for structural heart disease intervention ever get an evaluation for treatment. Please talk to your doctor if yor are concerned about the structural integrity of your heart.
Physicians: click here for more downloadable clinical information about these services. To refer a patient to our Structural Heart Program, call 803-673-0925 or fax orders to 803-256-5409.
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