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Structural Heart Clinic at Providence
Providing Minimally-Invasive Alternatives to Heart Surgery and Offering New Hope to Patients
Heart disease can be related to artery blockage (coronary artery disease), rhythmic disturbances (arrhythmias), how the muscle squeezes (cardiomyopathy), or anatomic defects (structural heart).
Structural heart conditions can be present at birth or they can develop due to aging, injury, or infection. Previously, if the condition was severe, the only option for treatment was open-heart surgery. Thanks to advances in the structural heart field of interventional cardiology, many of these conditions can now be treated with minimally-invasive alternatives, offering quicker recoveries, and fully covered by insurance.
We are proud to provide the Midlands first Structural Heart Clinic, developed to offer these alternatives to South Carolinians and open new doors for people who otherwise could not be treated.
Is the structure of YOUR heart a concern?
Symptoms of structural abnormalities vary widely depending on the area and degree of variation. Unfortunately, less than half of all patients that meet the criteria for structural heart disease intervention ever get an evaluation for treatment.
"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."
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
Minimally-Invasive Alternative to Heart Surgery
Minimally-invasive procedures involve entering the patient’s heart through an artery in the leg or arm instead of opening the chest to correct life-threatening or quality of life-reducing heart conditions. Because of the smaller entry point and reduced overall disruption to the body, these procedures have significantly shorter hospital stays and significantly faster and more comfortable recovery times. Here are some of the procedures offered today at the Providence Structural Heart Clinic.
Transcatheter Aortic Valve Replacement (TAVR)
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 patient's 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 patient's leg. People who are advanced in age or have coexisting conditions are still good candidates to have this procedure performed.
Transcatheter 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 patient's 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 to 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 an 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 listed above are currently available at the Providence Structural Heart Clinic in Columbia, SC. This clinic 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.
If you are concerned about the structural integrity of your heart, ask your doctor for a referral to the Providence Structural Heart Clinic.
Physicians: Click here for more downloadable clinical information about these services. To refer a patient to our Structural Heart Clinic, call 803-673-0925 or fax orders to 803-227-4140.
The Providence Structural Heart Clinic is located at 1655 Bernardin Avenue, Suite 350, Columbia, SC 29204.
Call (803)673-0925 to speak to a representative from the Structural Heart Clinic.
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