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Structural/Interventional Cardiology

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
  • Congential heart disease
  • Cardiomyopathy

If your primary 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 a medications or minimally invasive and interventional heart procedures such as:

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 it 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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