Structural Heart Program

An echocardiogram uses ultrasound to get a look at the structure of your heart. We place a sensor on your chest, which bounces sound waves off your heart to look for structural heart defects. Using electrodes similar to an ECG, the echocardiogram can also look for irregular heartbeats and attempt to narrow down which parts of your heart might not be functioning properly.

Although an echocardiogram can often tell us everything we need to know about the structure of your heart, sometimes it doesn’t give us enough detail. Interference from the ribs can sometimes make it hard to get the data we need. A transesophageal echocardiogram will give our team 3D images of the valve concern. A transesophageal echocardiogram uses an ultrasound sensor that we put down your numbed throat while you are comfortably sleeping to get a better look at your heart.

Both patent foramen ovale (PFO) and atrial septal defect (ASD) are holes between the upper chambers of the heart (the left atrium and the right atrium). In the past, patching these holes required open heart surgery. These days, we can repair both types of holes with endovascular treatments using catheterized tools. We insert the tools through your veins in the legs to reach the heart and place a closure device to seal your heart and improve heart function.

The aortic valve controls the flow of blood from the heart to the body. Unfortunately, in many people it doesn’t open enough to let blood flow freely into the body. This is called aortic valve stenosis, and if it’s not treated, you may suffer decreased blood flow to the body, which can lead to shortness of breath, general fatigue, and chest pain. It also forces the heart to work harder, which can lead to heart damage.

Threading either through the large artery in the groin, called the femoral artery, or an incision in the neck, TAVR doesn’t remove the old valve, but wedges a new valve in place, which opens properly. Sometimes this procedure is called transcatheter aortic valve implantation (TAVI).

The Watchman procedure closes off the left atrial appendage. Like the appendix, this small extra chamber in your heart doesn’t seem to have a significant function. However, it can cause significant problems because this is where most blood clots form that cause strokes in patients with atrial fibrillation (or an irregular heartbeat). This is a one-time procedure where we thread a device through a vein in your leg to your heart. The device closes off your atrial appendage to reduce your stroke risk.

The mitral valve can sometimes be leaky, allowing blood to flow back the wrong way when the heart beats. This can lead to shortness of breath, fatigue, lightheadedness, and a rapid heartbeat. The normal procedure to fix this is open heart surgery in which doctors stop and restart your heart. For some people, this is considered too risky. MitraClip is a less invasive procedure to repair the mitral valve. Working through a vein in the leg, we use a catheter to place the clip on your mitral valve to reduce the leaking which causes worsening symptoms.

Replacement heart valves can improve the function of your heart and extend your life. However, sometimes they don’t last as long as the patient. Just like your natural heart valves, surgical valves might develop stenosis (where the valve doesn’t open enough) or regurgitation (where the valve doesn’t close tightly enough and blood flows backward). Open heart surgery is the normal treatment for this – the old valve is removed and a new valve is placed in it’s position. However, if open heart surgery is too risky, we can use a valve in valve transcatheter approach, which pushes the old valve to the side so the new valve can take over. This procedure can be done for both aortic and mitral tissue surgical valves.