Structural Heart disease is a problem with the valves or tissues of the heart.
The UW Structural Heart Team offers many minimally-invasive, non-surgical options to treat these problems. Using catheters (small tubes inserted through veins or arteries), we can repair or replace damaged parts of the heart that might otherwise require open heart surgery.
Transcatheter Aortic Valve Replacement (TAVR)
Aortic stenosis is a condition in which one of the heart valves (the aortic valve) becomes stiff / narrowed, making it harder for the heart to pump blood out to the body. Aortic stenosis requires heart valve replacement as it is eventually fatal if left untreated and there are no effective medications to treat this condition. Transcatheter aortic valve replacement (TAVR) is a non-surgical aortic valve replacement option for patients diagnosed with severe aortic stenosis. In some cases, TAVR may also be used to treat patients with leaky aortic valves (aortic regurgitation) too. There are multiple types of TAVR valves made. The UW Structural heart team has access to all of them and will tailor the choice of valve to each individual’s scenario.
Mitral Valve Repair
Mitral Regurgitation is a condition in which one of the heart valves (the mitral valve) becomes leaky. Repair devices (for example, the Mitraclip device) reduces the leak using a so-called transcatheter edge to edge repair technique, which improves blood flowing through the heart in the appropriate direction and may reduce symptoms associated with mitral regurgitation, such as shortness of breath, fatigue or congestion. This is done using a small catheter (plastic tube) delivered from the leg/groin vein up to the heart.
Transcatheter Mitral Valve Replacement (TMVR)
Mitral Stenosis is a condition in which one of the heart valves (the mitral valve) becomes stiff and narrowed, making it harder for blood to flow through the heart. Transcatheter mitral valve replacement (TMVR) is a non-surgical mitral valve replacement option for patients diagnosed with mitral valve stenosis. In some cases, TMVR may also be used to treat patients with a leaky mitral valve (mitral regurgitation). Patients who have already had mitral valve surgery are often particularly good candidates for these therapies.
Transcatheter Tricuspid Valve repairs
The structural heart team offers non-surgical options to treat leaky tricuspid valves. A leaky tricuspid valve often results in swelling of the legs, stomach bloating, and / or fatigue. There are a number of new options to treat the tricuspid valve, some of which are currently offered only as part of a trial. Individualized treatment options are offered in consultation with the UW Structural Heart team.
Left Atrial Appendage Occlusion
Atrial Fibrillation (AF) is an abnormal cardiac rhythm, otherwise referred to as arrhythmia. Patients who have AF are at higher risk of developing a clot (thrombus) in a part of the heart known as the Left Atrial Appendage (LAA). When blood clots in the LAA , it can ultimately travel out of the heart to the brain potentially causing a stroke. Appendage occlusion devices (such as the Watchman) work by sealing the LAA and therefore eliminating the need to use blood thinners for stroke prevention in patients with atrial fibrillation.
Atrial or Ventricular Septal Defect Closure
Septal defects are typically small holes that can occur between the chambers of the heart. Occasionally, these holes require closing to restore normal blood flow through the heart. Catheter based closure can be offered to certain patients with these defects.
Paravalvular Leak closure
Paravalvular leak or “PVL” is a leak that can occur around a surgical or transcatheter valve replacement. These leaks allow blood to wash backwards away from the intended direction of blood flow and can lead to breathlessness or even enlargement of various chambers of the heart. Using a non-surgical transcatheter approach, small plugs inserted through a small plastic catheter and can be placed in the gaps around the valve to reduce the or eliminate these leaks.