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Structural Heart Disease

Structural Heart Disease Care at Allegheny Health Network

Allegheny Health Network’s is nationally renowned for treating patients with a vast array of structural heart disease conditions, many of whom are considered at high risk to undergo open heart surgery. Instead, our interventional cardiologists perform minimally invasive procedures that effectively treat these conditions and have the potential benefits of quicker recoveries, less pain, minimal scarring and reduced blood loss.

Because of their research and expertise, our physicians can treat an array of conditions through minimally invasive (percutaneous) methods, including advanced structural heart disease; valve leaks; congenital heart defects; malformations of the blood vessels in the heart; and patent foramen ovale. But no matter what type of structural heart disease you have, physicians at the Cardiovascular Institute can provide you with the most advanced and innovative solutions in treating your condition.

The progressive technologies and devices that our heart surgeons use to perform these procedures include:

  • Catheter-based devices that can be inserted through small incisions to perform techniques just as precise as a human hand
  • Novel and sleek instruments that can reach to your heart through your ribs without having to split your breastbone
  • Miniature cameras and 3-D, high-definition vision systems that give the surgeon a better view of different parts of your heart than with open heart surgery

 

Why the Cardiovascular Institute?

  • Among the best structural heart disease programs in the United States with physicians who are leaders in performing advanced techniques and using novel devices to treat heart conditions
  • Utilize the most sophisticated diagnostic tools to detect structural heart disease quickly and accurately
  • The only American Heart Association-accredited Heart Attack Receiving Center in western Pennsylvania
  • Multidisciplinary approach to cardiac care, illustrating teamwork on every front to ensure you are receiving an all-encompassing treatment plan that leads to a positive outcome
  • Patient-centric environment where our team focuses on you and your specific condition, symptoms and circumstances rather than treating every patient with the same approach

 

Treatment for structural heart disease depends on each patient’s condition and situation. Our multidisciplinary team collaborates to develop an optimal treatment plan that is specific to your case, needs and circumstances. We offer treatment options for:

Aortic valve disease

In mitral valve disease, the valve between your heart’s two left chambers doesn’t work properly. There are two types:

  • Aortic valve stenosis is when your mitral valve opening becomes narrowed. It causes your heart to pump blood with increased force in order to move blood through the valve.
  • Aortic valve regurgitation occurs when your valve does not close completely, causing blood to flow backward through the valve and into the left atrium. The condition also forces your heart to work harder to pump more blood on the next heartbeat.

 

Our treatments include:

  • Balloon valvuloplasty is performed to repair the valves of patients with narrowed mitral, aortic or pulmonary valves. It is a minimally invasive technique that involves inserting a thin, tiny hollow tube (catheter) with a balloon on its tip through a blood vessel in your arm or groin to your heart and into the narrowed valve. When in place, the balloon is inflated and deflated several times to stretch the valve opening and improve blood flow. The catheter and balloon are then guided back out of your body.
  • Transcatheter aortic valve replacement (TAVR) is a less invasive approach that involves replacing the bad aortic valve with a new one while your heart is still beating on its own. The valve is stitched inside of a stent, which is fed through the femoral artery (located in your groin) to your heart. A tiny balloon temporarily inflates inside the stent, setting the new valve in place. This is done through a few small incisions while the doctor views the procedure on a high resolution, 3-D camera and monitor.
  • Heart valve repair allows your own valve to remain in place while the surgeon makes repairs through a standard incision or through a minimally invasive approach.
  • Heart valve replacement involves open-heart surgery and support from a heart-lung bypass machine. The surgeon enters through your sternum and replaces the diseased valve with either a mechanical valve or an artificial (prosthetic) valve.
  • Minimally invasive valve replacement is when a surgeon performs heart surgery often going between your ribs or through a small incision in the sternum rather than dividing the breast bone completely as in traditional valve surgery. The surgeon uses magnified high definition 3D video monitoring to facilitate the surgery.

Atrial fibrillation

Congenital heart defect in adults (Atrial septal defect)

Before birth, you may have developed a hole between your heart’s upper two chambers (the atria). For some, smaller holes may close on their own during childhood. For others, large and long-standing atrial septal defects can damage your heart and lungs.

Our physicians can repair certain atrial septal defects (congenital heart defects) through these procedures:

  • Catheter-based closure of atrial septal defect (ASD) covers the hole in your atrium. A small tube called a catheter is inserted into your femoral artery (located in the groin) and threaded to your heart. Then a mesh patch, or plug, is placed over the opening in your heart.
  • covers the hole in your atrium that was present since birth. A small tube called a catheter is inserted into your femoral artery (located in the groin) and threaded to your heart. Then a mesh patch, or plug, is placed over the opening in your heart.

Mitral valve disease

In mitral valve disease, the valve between your heart’s two left chambers doesn’t work properly. There are two types:

  • Mitral valve stenosis is when your mitral valve opening becomes narrowed. It causes your heart to pump blood with increased force in order to move blood through the valve.
  • Mitral valve regurgitation occurs when your valve does not close completely, causing blood to flow backward through the valve and into the left atrium. The condition also forces your heart to work harder to pump more blood on the next heartbeat.
 

Our treatments include:

  • Balloon mitral valvuloplasty involves inserting a thin, tiny hollow tube (catheter) with a balloon on its tip through a blood vessel in your arm or groin to your heart and into the narrowed valve. When in place, the balloon is inflated and deflated several times to stretch the valve opening and improve blood flow.
  • Robotic minimally invasive mitral valve surgery can treat defective mitral valves and those damaged by infection or aging by reconstructing the valve from your own tissue or replacing it with an artificial valve. The surgeon reaches your valve through a few small incisions in the side of your chest and inserts a high-definition camera to see a 3-D view of your valve and surrounding heart structure. The physician then uses the robotic system to control the movement of the instruments that repair or replace your valve. The Cardiovascular Institute is one of only a few medical centers in the country performing this groundbreaking procedure.

Patent ductus arteriosus

Typically after birth, the ductus arteriosus – small part of your heart – closes naturally on its own. But for some, it does not close and can cause too much blood to flow through the heart, weakening the heart musical and potentially causing heart failure. Others may never need treatment because they don’t experience any symptoms or problems.

Our minimally invasive procedure to treat patent ductus arteriosus:

Catheter-based closure of patent ductus arteriosus involves inserting a thin, tiny hollow tube (catheter) through a blood vessel in your arm or groin to your heart and toward your heart. When the catheter is in place, a plug or coil is inserted to close the ductus arteriosus to repair the open duct.

Patent foramen ovale

Before birth, you have a normal opening – called a foramen ovale – between the left and right atria of your heart. If this opening doesn’t close naturally soon after birth, it results in a patent foramen ovale, or a hole in the heart. Typically, the condition doesn’t cause significant health problems and doesn’t require treatment. However, if the condition is found and diagnosed, you may need this minimally invasive procedure to close the opening:

Catheter-based closure of patent foramen ovale closes the flap on your heart. A small tube called a catheter is inserted into your femoral artery (located in the groin) and threaded to your heart. Then a mesh patch, or plug, is placed over the opening in your heart.

Peripheral artery disease

Peripheral artery disease, also called lower extremity arterial disease, occurs when fatty deposits called plaque buildup inside the arteries outside of the brain and heart. Clogged arteries cause decreased blood flow to your heart, which may cause you to have leg pain, chest pain and shortness of breath.

 

While the earliest signs of peripheral vascular disease are subtle, your condition can be successfully diagnosed and treated with our advanced techniques, including:

may include pump therapy, manual drainage through massage therapy and various wrappings.

Anticoagulation management is blood-thinning medications to help prevent blood clots.

Balloon angioplasty/stentsis a minimally invasive procedure where a small hollow tube called a catheter is inserted into your femoral artery (located in the groin) and threaded to your clogged artery. Once the catheter is in place, a balloon is inflated to widen the artery, and a small wire mesh coil called a stent is inserted to keep your artery from narrowing again.

Thrombolytic therapy/mechanical thrombectomyis a minimally invasive procedure where a small hollow tube called a catheter is inserted into your femoral artery (located in the groin) and threaded to your clogged artery. A clot-dissolving medication inside of the catheter is delivered directly to blockages, or a special catheter can be used to disrupt and remove clots.

Bypass surgery is when a surgeon creates a graft using healthy arteries or veins from another part of your body to bypass blocked portions of your coronary arteries. This allows blood to flow around the narrowed artery.

Radiofrequency ablation for saphenous veinis a minimally invasive procedure that uses radiofrequency energy to open or remove your saphenous vein. It involves inserting a small tube called a catheter into your femoral artery (located in the groin) and threading it to your vein. Utilizing radiofrequency energy and the heated catheter, the physician cauterizes – or burns – the tissue surrounding your saphenous vein to close it.

Lutonix ® 035 is a device that delivers medication to the arteries via a drug-coated balloon. It improves blood flow through blocked arteries in the short term by using an angioplasty balloon to push plaque tight against the arterial wall, creating a larger channel for blood flow. The balloon then transfers a low dose of Paclitaxel, a cell-growth inhibitor, into the arterial wall to prevent plaque from reforming in the future. Allegheny Health Network is the first health system in the region to offer this innovative treatment for PAD.

Pulmonary valve disease

Pulmonary valve stenosis occurs when the blood flow from your heart to your lungs is slowed by an abnormal or narrow pulmonary valve. Normally, the condition occurs before birth as a congenital heart defect, but sometimes adults develop the condition as a complication of another illness.

Our minimally invasive procedure to treat pulmonary valve disease:

Balloon pulmonary valvuloplasty involves inserting a thin, tiny hollow tube (catheter) with a balloon on its tip through a blood vessel in your arm or groin to your heart and into the pulmonary valve. When in place, the balloon is inflated and deflated several times to stretch the valve opening and improve blood flow.

Tricuspid valve disease

Tricuspid valve disease is occurs when the valve between the two right heart chambers (right ventricle and right atrium) doesn't function properly. There are several types of tricuspid valve disease, including:

Tricuspid valve stenosis is when your tricuspid valve becomes narrowed. It decreases the amount of blood that can flow through the valve from the right atrium to the right ventricle.

Tricuspid valve regurgitation is when your tricuspid valve doesn't close properly and blood flows back into your heart's upper right chamber (right atrium).

Tricuspid atresia is a condition present at birth (congenital heart disease) where a solid wall of tissue blocks the blood flow between your right heart chambers.

Ebstein's anomaly is when you have a malformed tricuspid valve that sits lower than normal in the right ventricle, causing blood to flow back into your right atrium (tricuspid regurgitation).

Our treatment includes:

Tricuspid valve surgery is when a surgeon reaches your valve through a few small incisions and inserts a high-definition camera to see a 3-D view of your valve and surrounding heart structure. The robotic system is used to control the movement of the instruments that repair or replace your valve. Your heart is frequently allowed to beat on its own with this type of operation rather than placing you on a heart-lung machine.

Ventricular septal defect

Before birth, you may develop a hole between their heart’s lower two chambers (ventricles). For some, smaller holes may close on their own during childhood. For others, larger ventricular septal defects need surgically closed to prevent complications, such as damage to your heart valves.

Our minimally invasive procedure to treat ventricular septal defect:

Catheter-based closure involves inserting a thin, tiny hollow tube (catheter) through a blood vessel in your arm or groin to your heart and toward your heart. When the catheter is in place, a plug or coil is inserted to close the opening.