Structural cardiologists treat patients who suffer from conditions that
affect the heart’s valves, walls, chambers, or muscles. Structural
heart disease can appear at birth or develop with age. Common symptoms
of structural heart disease can include but are not limited to heart palpitations,
high blood pressure, stroke, and chest pain.
The most common types of structural heart disease are:
Valvular heart disease
Congenital heart disease
Cardiomyopathy
If your primary care provider suspects you have potential for heart disease,
they will refer you to a cardiologist. Cardiologists will perform diagnostic
tests to determine the correct diagnosis.
Treatment will vary based on the condition. If you are diagnosed with a
structural heart disease you may be treated with medications or minimally
invasive and interventional heart procedures.
Transcatheter Aortic Valve Replacement (TAVR)
The heart functions by pumping blood through four chambers with help from
the heart valves. The aortic valve controls blood flow to the body. If
this valve becomes diseased, it can result in a valve that is too stiff
or too weak. This makes your heart work harder to get blood out to your
body. In the TAVR procedure, the physician inserts a tube into an artery,
then guides the artificial valve to the heart to replace the diseased
valve. This is much less invasive than open heart surgery.
Transcatheter Mitral Valve Repair (MitraClip)
When the mitral valve becomes diseased, resulting in a weak or leaking
valve, the physician can repair it by using an implanted clip. The clip
will grasp the leaflets (flaps of tissue) to close the center of the valve.
This can reduce mitral regurgitation or leaking.
Left Atrial Appendage Closure
More than 90% of stroke-causing clots come from the left atrial appendage
(a small, ear-shaped sac in the wall of the top left chamber of the heart).
Using this device, the physician is able to close off the appendage, preventing
blood clots from traveling out of the appendage and to the brain.
Endovascular Aortic Repair (EVAR)
An aneurysm is a bulging area of a blood vessel. The aorta can become weak
due to age, disease, or trauma. As the bulge grows, the wall of the aorta
becomes weaker. This can lead to rupture and massive internal bleeding.
A stent graft can be placed inside the aneurysm. This reduces the pressure
on the aneurysm and reduces the risk of rupture.
PFO/ASD Closure
PFO (patent foramen ovale) and ASD (atrial septal defect) are both conditions
in which there is a hole between the right and left upper chambers of
the heart that did not close properly after birth. Blood is able to flow
between the right upper chamber and the left upper chamber of the heart.
This can often lead to a stroke. The physician can place a device over
this hole to stop blood from flowing improperly through it.
Balloon Valvuloplasty
In patients with valvular stenosis, a catheter can be inserted into the
heart and guided to the narrowed valve. The balloon is then inflated,
which expands the opening of the valve.
Alcohol Septal Ablation
There is an inherited condition, called hypertrophic cardiomyopathy, where
the heart muscle is abnormally thick. The thickened wall may block blood
flow out of the heart. Alcohol septal ablation is done to reduce the overgrowth
of this heart muscle.
Interventional Procedures
Right and Left Heart Catheterization/Coronary Angiography
Cardiac catheterization is the insertion of a catheter into a chamber or
vessel in the heart. The physician can measure the pressures within the
heart as well as assess for coronary artery disease.
Carotid/Renal/Peripheral Angiography
The physician inserts a catheter into the carotid arteries, renal arteries,
as well as the arteries that supply the legs. Contrast is then used to
assess for blockages or narrowing under x-ray.
IVC Filter Placement & Retrieval
An IVC Filter is a small metal umbrella-like device that traps blood clots
and prevents them from traveling to the heart and lungs. It is placed
by accessing a vein in the groin. It is removed in a similar fashion.
Transesophageal Echocardiogram
A probe is passed into the esophagus and ultrasound waves are used to examine
the structures of the heart.
Direct Current Cardioversion
An electrical impulse is passed along electrodes placed over the chest
in order to return the heart rhythm to normal.
Catheter Assisted Thrombolysis
The physician is able to place a catheter directly into blood clots, that
then use ultrasound to deliver low doses of clot dissolving drugs.
Thrombectomy
The physician is able to remove blood clots by aspirating them through
a catheter that is placed in the groin.
Loop Recorder
The physician places an insertable cardiac monitor under the skin in the
upper chest. This device can record and relay your heart rhythm continuously
for up to three years.
Pericardiocentesis
The physician uses a needle and small catheter to remove fluid that has
built up in the sac around the heart.
Endovenous Ablation
The physician uses energy to cauterize (burn) varicose veins. This closes
them, easing symptoms such as pain, swelling, and irritation.
Impella
The physician places a temporary percutaneous heart pump through an artery
in the groin. This helps to maintain blood flow and take over some of
the work of the heart.
Intraortic Balloon Pump
The physician places a catheter into the artery in your groin. This catheter
has a balloon at the end that inflates and deflates to help your heart
pump more blood.
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