Structural Heart Disease
Your heart’s structure keeps the blood flowing.
Unblock your path to healthy living.
Overview
The components of the structural heart—the heart’s walls and muscle, valves and arteries—push blood through your heart’s four chambers, out to your brain and other parts of the body, and back to your lungs. Sometimes, you’re born with a structural heart defect. One or more parts can become impaired due to disease, injury or wear. Common symptoms include shortness of breath, fatigue, chest pain, leg or foot swelling and an irregular heartbeat. St. Luke’s Structural Heart Specialists are experts in treating structural heart disease using the latest medicines and techniques.
Heart valves
The heart contains four single-direction valves that help regulate blood flow. A diseased or damaged valve cannot move blood in the right amount or direction, affecting a person’s breathing, energy level, thinking ability and level of physical activity. Valves can be replaced, and sometimes repaired, by open-heart surgery or new catheter-based techniques. There are four types of valves:
- The aortic valve regulates blood leaving the heart and entering the aorta, the largest artery in the body.
- The mitral valve connects the upper (atrium) and lower (ventricle) chambers on the left side of the heart. In a healthy heart, blood passes only through from the upper to the lower chamber.
- The tricuspid valve lies between the heart’s right upper and lower chambers, through which blood flows.
- The pulmonary valve regulates blood flow to the pulmonary artery and lungs, where it gives off carbon dioxide and becomes enriched with oxygen.
Conditions we treat
Atrial septal defect
An atrial septal defect is a birth defect in which a hole in the wall (septum) divides the heart’s upper chambers (atria). This condition can cause shortness of breath, fatigue, swelling of the legs, heart palpitations, irregular heartbeats, or stroke. Treatment options include open heart surgery or the insertion of a ‘closure device’ fitted onto a catheter.
Hypertrophic cardiomyopathy (HCM)
Hypertrophic Cardiomyopathy (HCM) is an abnormally thick wall muscle (septum) separating the heart’s lower right and left chambers. This can cause lightheadedness and fatigue during mild exercise and sometimes results in sudden cardiac death, especially in athletes. Medications can treat HCM symptoms, but open-heart surgery to correct the septum is the only cure.
Left atrial appendage occlusion (LAAO)
The left atrial appendage is a pocket on the left side of the heart where blood can collect and clot. If this occurs, the blood clot can flow up to the brain and cause a stroke. Blood thinners can prevent clot formation, and closing off the pocket with an implantable device can avert blood collection in this location. Patients with atrial fibrillation are five times more likely to have a stroke because of the increased formation of blood clots. While blood thinners are the most common treatment for atrial fibrillation, people with bleeding issues cannot tolerate them.
In these instances, you may qualify for a special transcatheter device to close the left atrial appendage, reducing stroke risk. During implantation, physicians thread the device through a thin, flexible tube into the patient’s heart and position a small cap-like device that expands and blocks the opening of the left atrial appendage. This procedure takes about an hour, during which the patient is under anesthesia. Patients are discharged home the next day and typically recover quickly.
Patent foramen ovale (PFO)
Patent foramen ovale (PFO) is a small hole between the upper heart chambers that doesn’t close at birth. It is usually found in adults, often following a stroke. PFO is treated with surgery or by inserting a closure device with a catheter. In some cases, blood thinners prevent blood clots from forming.
Ventricular-septal defect
Ventricular-septal defect is a hole in the muscle (septum) between the two lower chambers that is present at birth. A person with this condition might feel short of breath when exercising, tire easily, have swelling of the legs, experience heart palpitations and possibly suffer a stroke. Treatments range from medications to surgery or the insertion of a ‘closure device’ using a catheter.
Treatments
Mitraclip™
MitraClip™ is a simple procedure to fix your mitral valve and restore normal blow flow through your heart. During the procedure, doctors access the mitral valve with a thin tube called a catheter guided through a vein in your leg to reach your heart. A physician attaches an implanted clip to your mitral valve to help it close more completely.
Transcatheter aortic valve replacement (TAVR)
TAVR is a less invasive procedure in which the diseased aortic valve is replaced by inserting a balloon-expandable heart valve into the body. While you are under general anesthesia, a physician inserts a tube called a catheter through a small incision in the femoral artery in your upper leg. After the operation, which usually takes about three hours, you’ll recover in the Intensive Care Unit. While you are recuperating, your doctor will check your heart function using electrocardiography, ultrasound and X-rays during your hospital stay, usually about eight days. After being discharged from the hospital, you’ll have regular visits with your cardiologist and primary care doctor to ensure that your valve is performing correctly and that your symptoms are improving. If you experience symptoms like shortness of breath or fatigue, contact your doctor right away.
Transcatheter mitral valve replacement (TMVR)
Transcatheter mitral valve replacement (TMVR) is a procedure to replace a faulty heart valve. Less invasive than open-heart surgery, TMVR implants a manufactured valve or one made from a cow, pig or human-biological heart tissue in the place of your original valve. The human-made valve then replaces and restores the function of the defective valve.
Valve surgery
There are many types of surgery and procedures to replace damaged or diseased heart valves. Methods include open-heart and minimally invasive heart surgery. The best type for you depends on your age, overall health, and the type and severity of your heart valve disease.
