Solving Structural Heart Problems

Read Solving Structural Heart Problems

Solving Structural Heart Problems
When the valves and chambers in your heart aren’t working correctly, a specialized heart team with experience can make the difference.

Structural heart disease describes any defect with the anatomy of your heart or chambers. Whether it’s the valves that control blood flow, the chambers that make up your heart or a problem with the aorta, structural heart disease can lower your quality of life and put you at increased risk for potentially life-threatening heart health concerns, such as heart failure or stroke.

Some common structural heart problems include:

  • Valve stenosis (narrowing). When blood flows from one area of the heart or body to another, it passes through a valve, which acts as a gateway in or out of the heart. The aortic valve controls blood flow from the heart to the rest of the body. The mitral valve controls blood flow between the two chambers on the left side of the heart. And the pulmonary valve controls blood flow out of the heart and into the lungs. All can have narrowing. Left untreated, valve stenosis can cause irregular heartbeat, stroke, heart failure or loss of life.
  • Mitral valve regurgitation. When the mitral valve does not close properly, it can allow blood to flow backward, leading to heart failure and arrhythmia. Degenerative mitral regurgitation (wear and tear) along with mitral valve regurgitation caused by other conditions, such as coronary artery disease or heart muscle problems, are common causes of mitral regurgitation. If severe enough, mitral valve regurgitation can cause heart failure.
  • Atrial septal defect (ASD). A wall of tissue separates the upper chambers of the heart. An ASD is a hole in the tissue that allows oxygen-rich blood to flow into the oxygen-poor part of the heart. Symptoms vary depending on the size of the hole.

Treatment Requires a Skilled Team

Although medications can sometimes be used to manage symptoms of structural heart problems, surgery or a minimally invasive procedure may be the best treatment option.

“This subset of heart disorders is very complex and requires a collaborative team approach to address effectively,” said Nezar Falluji, MD, MPH, FACC, FSCAI, board-certified interventional cardiologist with KentuckyOne Health Cardiology Associates–Lexington. “At KentuckyOne Health, we offer a comprehensive, multidisciplinary approach. We combine the skills of interventional cardiologists, who specialize in structural heart disease, with those of cardiovascular surgeons to provide the best evidence-based pharmacologic, minimally invasive and surgical intervention care.”

A Minimally Invasive Approach to Treating AVS

If you are dealing with aortic valve stenosis (AVS), you know how exhausting the condition can be. For patients with severe AVS who are not ideal candidates for surgical replacement, implanting a prosthetic aortic valve using a minimally invasive approach saves lives and improves quality of life. This approach is known as transcatheter aortic valve replacement (TAVR).

At Saint Joseph Hospital and Jewish Hospital, both part of KentuckyOne Health, physicians use a catheter to place the replacement valve within the old, damaged valve, almost like a stent. The new valve takes over, and normal blood flow is restored. At KentuckyOne Health, TAVR is performed under conscious sedation, which improves patients’ recoveries and decreases hospital length of stay.

“The quality of life prior to aortic valve replacement is poor, and patients with aortic valve stenosis can’t do any type of activity that requires exertion — climbing the stairs, walking more than a block or doing things they want to do become impossible,” said Michael Flaherty, MD, PhD, board-certified interventional cardiologist, associate professor of medicine and physiology at the University of Louisville and director of adult structural heart disease at Jewish Hospital.“Fixing the valve not only improves patients’ quality of life, but is lifesaving. All those limitations are gone. When we perform the replacement with a catheter and use conscious sedation, patients are up and walking around the day of the procedure and go home the next day.”

Fixing Blood Flow Without Surgery

Patients with mitral valve regurgitation also face exhaustion, extreme fatigue and shortness of breath. If you have severe leakage but are not a candidate for surgery, the MitraClip system can help.

Available at Saint Joseph Hospital and Jewish Hospital, this system uses a nonsurgical puncture and a catheter to place a clip on the mitral valve. MitraClip allows the valve to close more completely, reducing the backflow of blood.

This article originally appeared in the Winter 2017 edition of One Health magazine. For more stories like this one, subscribe to One Health today