Structural cardiology focuses on services and procedures intended to help patients with structural heart disease. Structural heart disease can develop with age or can be congenital, or present at birth. Hattiesburg Clinic strives to provide quality care in the area of structural heart disease. Depending on the condition of the patient, a variety of procedures specific to structural cardiac care include:
Balloon valvuloplasty is a procedure to assist with a heart valve with stenosis. A stiff/narrow valve, or one that is stenotic, causes the heart to work harder to pump blood. There are several causes of valve stenosis, which may include:
During balloon valvuloplasty, a catheter is inserted through the patient’s artery in either the groin or the arm and thread to the heart. When the catheter reaches the destination of the narrow valve, a balloon at the end is inflated and opens the valve. During the procedure, the patient typically remains awake but may be given a sedative to relax.
Balloon valvuloplasty is typically most effective in children, teens and young adults. This procedure is less effective in older adults who may require a valve replacement.
For patients who are at risk of having a stroke due to carotid artery disease, the doctor may recommend carotid endarterectomy, which is a procedure intended to open or clear the carotid artery when plaque, or fatty deposits, have developed. Removing the plaque allows for improved blood flow through the artery and reduces the risk of a stroke.
During carotid endarterectomy, the patient may receive a local or general anesthetic. An incision will be made along the front of the patient’s neck, where the surgeon will then go in to remove the plaque. Stitches or a patch graft made of artificial material may be used to close the incision once the procedure is complete.
Left atrial appendage (LAA) closure is a procedure that is intended to benefit patients with atrial fibrillation. Atrial fibrillation is when electrical impulses that manage the heartbeat do not function properly and the LAA, a small pouch inside the heart, collects blood, which can form into clots. A blood clot in the LAA can release into the heart and cut off blood supply to the brain, causing a stroke.
If a patient is at risk of a stroke due to blood clots in the left atrial appendage, the doctor may recommend a closure procedure. Hattiesburg Clinic offers Watchman, an implant to prevent clotting in the LAA. Watchman can be helpful in eliminating the need for frequent blood tests and the need to take blood thinners, which are another means to prevent blood clots.
The Watchman device is a small, parachute-shaped piece that is implanted during a minimally invasive catheter procedure that does not require surgery. A catheter is inserted into a vein near the groin and guided to the LAA. The Watchman device seals off the LAA to prevent it from releasing potentially dangerous clots.
Atrial septal defect is a defect of the heart in which there is a hole in the wall that divides chambers in the heart. According to the Centers for Disease Control and Prevention (CDC), there are an estimated 1,966 babies born each year in the United States with an atrial septal defect. This defect may be identified during pregnancy, but individuals can also not know of their defect until adulthood, and the exact cause of it is not known. Most patients have an audible heart murmur that is caused by the extra blood flow.
An infant with an atrial septal defect identified before or at birth may not need immediate intervention and on some occasions, the defect may repair itself over time. Surgery may be recommended and is dependent on the advice of a physician. To repair or close an atrial septal defect, catheterization, a keyhole incision or open-heart surgery may be performed. Depending on the size of the defect, it may be repaired by using a suture and sewing it closed, or for larger defects, a patch may be used to cover and close the hole.
Similar to how a stent can be placed in an artery, a replacement valve can be inserted to the valve site. Once inserted, the new, artificial valve pushes the old valve out of the way and takes over regulating blood flow. TAVR can be performed without opening the chest and may be a good option for patients not able to have open-heart surgery.
Transcatheter Mitral Valve Repair (TMVR) may be recommended for patients with mitral valve regurgitation (leaky valve), which is when the mitral valve does not close completely, causing blood to flow back into the upper chamber. This causes the heart to pump harder. According to the Centers for Medicare & Medicaid Services, mitral regurgitation is the most common type of heart valve insufficiency in the United States and can cause heart failure or rhythm problems.
The MitraClip™ is a small, metal clip that is implanted through a non-invasive catheter procedure. It prevents regurgitation by clipping and holding a small part of the valve, allowing the valve to close properly and restoring normal blood flow. A catheter is inserted into a vein near the groin and directed to the mitral valve. Once at the valve, the catheter will open and the doctor will place the clip precisely to reduce regurgitation.