Structural Heart Disease Treatments

When you have structural heart disease, your heart valves don’t function correctly. This can interrupt the natural flow of blood through your heart. There are different kinds of structural heart disease and many ways to treat it. At Wake Forest Baptist Medical Center, we helped test and pioneer the best available devices for structural heart disease. 

Minimally Invasive Structural Heart Disease Treatment 

Treatment of structural heart disease addresses the two main types of structural heart defects: 

  • Valvular conditions: Valves in your heart are narrow or do not close completely, preventing blood from flowing with proper force and direction through your heart. This causes your heart to work harder than it should. 
  • Congenital conditions: Some people are born with heart conditions that may not require treatment until they reach adulthood, such as a hole in the heart wall (septum). 

At Wake Forest, we use minimally invasive surgery whenever possible. We are able to treat many structural heart conditions using cardiac catheterization procedures. Cardiac catheterization uses thin, flexible tubes (catheters) and advanced imaging technology to access your heart and arteries. We can often access the arteries through tiny incisions in your leg. 

Structural Heart Defect Treatments in North Carolina 

We provide expert care and treatment for a broad range of structural heart disease conditions. Available treatments include: 

Melody® Valve 

When a mitral valve doesn’t function properly, it can be life-threatening. Treatments to replace the diseased valve can restore good blood flow. However, children can outgrow their replacement valves. Repeat surgeries to adjust and replace valves can put strain on their developing bodies. Adults with leaky mitral valves may also need additional surgeries as well. The Melody® valve is the first FDA-approved valve of its kind, supporting a lifetime of mitral valve disease management with just one replacement procedure. 

  • The Melody® valve is a specially designed valve that can adjust to fit a variety of sizes: 
  • The full-size valve allows for treatment in adults. 
  • Children receive a cinched down version. Advanced technology allows us to adjust the valve as the child grows without needing to perform additional surgeries. 

Here’s how it works:

  1. You receive medication to put you (or your child) to sleep and ease any discomfort. 
  2. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter) that has a balloon at the tip with the Melody® valve attached. 
  3. The balloon is inflated to open up the Melody valve and place it into position. 
  4. We deflate and remove the balloon and catheter. 
  5. The Melody® valve immediately replaces your old heart valve 
  6. We can adjust the valve using a catheter-based procedure. 

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MitraClip 

MitraClip is a permanent implant that attaches to tissue within your mitral valve and keeps blood flowing in the right direction. Wake Forest Baptist Medical Center is among the first hospitals in the country offering this new device. 

Mitral heart valves keep blood flowing forward through your heart and the rest of your body. Within the valve, tissue flaps known as leaflets snap open and shut with each heartbeat. Healthy leaflets form a tight seal so that blood can’t escape. When you have mitral valve disease, the leaflets allow blood to leak backward. Symptoms worsen over time, which leave you feeling weak and make it difficult to perform everyday tasks. 

Some people with advanced forms of mitral valve disease are too weak from the condition to withstand surgery. MitraClip offers a nonsurgical alternative. Here’s how it works: 

  1. Before treatment, you may undergo one or more cardiovascular imaging tests, such as an ultrasound of the heart, to pinpoint the source of the leak. 
  2. We give you medication to put you to sleep and ease any discomfort. 
  3. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter) with the MitraClip attached 
  4. We guide the catheter through your blood vessels to deliver the MitraClip to the diseased mitral valve. 
  5. Using special instruments and advanced imaging technology, our experts permanently attach the MitraClip to the leaflets of your mitral valve exactly where the leak is most severe. 
  6. We remove the catheter, and your procedure is complete. 
  7. After the procedure, we perform additional imaging tests and blood work to make sure the MitraClip is working properly. 
  8. You also may need to take medication such as blood thinners or aspirin for a short period of time. 

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Mitral Valvular Plasty

Also known as valvuloplasty, this nonsurgical procedure “reshapes” the mitral valves. Valvuloplasty treats mitral stenosis, a narrowing of the mitral valve that can block the flow of blood to the main pumping chamber of your heart. This form of heart disease is relatively rare and requires expert treatment. 

Mitral valvular plasty is a minimally invasive procedure to open up stiff or scarred heart valves. Here’s how it works: 

  1. We give you medication to help you relax and ease any discomfort. 
  2. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter) with a balloon attached. 
  3. Your doctor advances the catheter through your blood vessels to the damaged valve. 
  4. Using advanced imaging technology, real-time pictures of your heart and blood vessels display on a monitor to help our team pinpoint the areas that need treatment. 
  5. We inject a special dye through the catheter to show your valve’s movement in greater detail. 
  6. You may feel some effects from the dye, such as a flushing sensation or a metallic taste in your mouth, but these effects usually last only a few moments. 
  7. Doctors guide a balloon catheter to the site of the diseased valve. 
  8. We repeatedly inflate and deflate the balloon, pushing the diseased tissue out of the way so that blood can flow normally. 
  9. Once the valve is open, we remove the catheter and the procedure is complete. 
  10. You may need to stay overnight in the hospital so we can monitor your recovery. 

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Paravalvular Leak Closure 

A paravalvular leak is a rare occurrence and happens when a replacement valve does not stay in place. When this happens, the valve allows small amounts of blood to flow around it or backward instead of through it. Large leaks can lead to heart failure and increase your risk for infection, so it’s important to get treatment right away. The good news is that a nonsurgical procedure can close the leak. 

Paravalvular leak closure involves inserting small plugs or coils inside the gaps next to the replacement valve. Here’s how it works: 

  1. Before treatment, you may undergo one or more cardiovascular imaging tests, such as an ultrasound of the heart, to pinpoint the source of your leak. 
  2. We give you medication to put you to sleep and ease any discomfort. 
  3. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter) with the closure device attached.
  4. Your doctor guides the catheter through your blood vessels, delivering the closure device to the source of the leak. 
  5. Using special instruments and advanced imaging technology, our experts permanently attach the closure device to your tissue or the valve to seal off the leak. 
  6. We remove the catheter, and your procedure is complete. 
  7. After the procedure, we perform additional imaging tests to make sure the closure is secure. 

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Patent Foramen Ovale/Atrial Septal Defect Closure 

Patent foramen ovale (PFO) and atrial septal defect (ASD) are holes in the wall that separates the two upper chambers of your heart. These conditions are present at birth. However, some people don’t know they have it until they reach adulthood. PFO and ASD allow oxygen-rich blood to leak into the oxygen-poor chambers of the heart. Over time, pressure in the lungs can build up, leading to lower oxygen levels in the blood that goes to the body. 

PFO/ASD closure is a routine procedure to close holes in the upper chambers of the heart. Here’s how it works: 

  1. Before the procedure, you will undergo a cardiovascular imaging test, such as an echocardiogram, to pinpoint the shape and size of the hole and make sure no other defects are present. 
  2. We give you medication to help you relax. 
  3. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter) with a closure device attached to the tip.  
  4. The closure device consists of a short tube with discs on either end. The discs are covered in special mesh material. 
  5. The device is compressed to fit on the delivery end of the catheter and advanced through your blood vessels to the hole. 
  6. We check the positioning of the devices using advanced imaging technology. 
  7. Once we are sure of the positioning, the short tube plugs the hole and the discs expand to straddle each side of the hole. One is in the left atria, and the other is in the right atria. 
  8. We remove the catheter, and the procedure is complete. 
  9. You will need to stay in the hospital and rest for at least six hours afterward. 
  10. Within 24 hours, we perform imaging tests to make sure the device is positioned correctly. 
  11. The device will stay in your heart permanently. Within a few days, your tissue will begin to grow over it. 

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Patent Ductus Arteriosus (PDA) Closure 

Patent ductus arteriosus (PDA) is an unclosed hole in the aorta, the main artery of your body. This condition primarily affects premature babies whose lungs did not fully develop before they were born. At Wake Forest, our partnership with the pediatric experts at Brenner Children’s Hospital allows us to provide a superior level of care to our patients. 

PDA closure is a nonsurgical procedure that reduces a child’s risk of infection in the inner lining of the heart chambers and valves. Here’s how it works: 

  1. Before the procedure, your child receives one or more cardiovascular imaging tests, such as an angiogram, to pinpoint the shape and size of the hole. 
  2. Your child will receive medication to help him or her relax or go to sleep (depending on the age). 
  3. A pediatric cardiology specialist makes an incision in your child’s artery and inserts a thin, spaghetti-like tube (catheter) with either a coil or plug-shaped device attached to the other end. 
  4. We then advance the catheter through your child’s blood vessels to the ductus arteriosus. 
  5. We insert the coil or plug into the hole using special instruments and advanced imaging technology. 
  6. We remove the catheter, and the procedure is complete. 
  7. Your child will probably not need to stay overnight in the hospital. 

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Transcatheter Aortic Valve Replacement 

Transcatheter aortic valve replacement (TAVR) is an innovative procedure that delivers replacement valves via catheter for patients with severe aortic stenosis. Wake Forest Baptist Medical Center was one of only two hospitals in the country who participated in clinical trials to test this procedure. We also offer some of the most sophisticated replacement devices, including the Sapien Transcatheter Aortic Replacement Valve. 

Aortic stenosis is an abnormal narrowing of the aortic valve. This condition prevents heart valves from functioning properly and forces the heart to work harder to pump blood. Eventually, this extra work can weaken your heart to the point that surgical repair is more risky than the disease itself. However, without some form of treatment, this condition can cause a life-threatening heart condition. 

Here’s how it works: 

  1. We give you medication to put you to sleep. 
  2. An interventional cardiologist makes an incision in your artery and inserts a thin, spaghetti-like tube (catheter). 
  3. The tip of the catheter contains the compressed replacement valve on a balloon delivery device. 
  4. A thin wire helps guide the replacement valve up to the aorta. 
  5. Using advanced imaging technology, our experts check the valve for proper placement on special monitors. 
  6. Once in place, the balloon expands, wedging the replacement valve permanently into place. 
  7. As the new valve expands, it pushes the diseased valve tissue out of the way. 
  8. The tissue in the replacement valve takes over the job of regulating blood flow. 
  9. You may need to stay overnight in the hospital so we can monitor your recovery. 

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Ventricular Septal Defect Closure 

Ventricular septal defect (VSD) is a hole in the septum (wall) that separates the two lower (ventricular) chambers of your heart. VSD is present at birth and allows oxygen-rich blood to leak into the oxygen-poor chambers of the heart. It is the most common congenital heart defect. 

VSD can become a medical concern when the holes: 

  • Don’t close on their own 
  • Are large enough to cause symptoms such as rapid breathing 

Over time, a VSD can cause pressure in your lungs to build, leading to less oxygen in blood going out to the body. Sometimes this happens in childhood, but in some people VSDs don’t cause problems until adulthood. When this happens, surgery is needed to close the hole. Here’s how it works: 

  1. Before the procedure, you or your child will receive a cardiovascular imaging test, such as an echocardiogram, to pinpoint the shape and size of the hole and make sure no other defects are present. 
  2. We’ll give you or your child medication to help them fall asleep. 
  3. Our specialist makes an incision in you or your child’s artery and inserts a thin, spaghetti-like tube (catheter) with a closure device attached to the tip. 
  4. The closure device consists of a short tube with discs on either end. The discs are covered in special mesh material. 
  5. The device is compressed to fit on the delivery end of the catheter and advanced through a blood vessel to the hole. 
  6. We’ll check the positioning of the devices using advanced imaging technology. 
  7. Once we are sure of the positioning, the short tube plugs the hole. The discs expand and straddle each side of the hole. One is in the left atria, and the other is in the right atria. 
  8. We remove the catheter, and the procedure is complete. 
  9. You or your child will need to stay in the hospital and rest for at least six hours after the procedure. 
  10. Within 24 hours of the procedure, we perform imaging tests to make sure the device is positioned correctly. 
  11. The device will remain in place permanently. Within a few days, tissue will begin to grow over it. 

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Contact Us 

Request an appointment online. Or, for more information, please call: 

  • 336-716-WAKE or 
  • 888-716-WAKE (toll-free) 

 

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Last Updated: 05-26-2014
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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.