Structural Heart & Valve Treatments

For patients who have been diagnosed with severe aortic valve stenosis and who are high-risk or too sick for open-heart surgery, transcatheter aortic valve replacement (TAVR) may be an alternative to receive a new heart valve without undergoing open-heart surgery.

Here at Torrance Memorial Medical Center, our interventional cardiologists and cardiac surgeons on staff have extensive experience performing TAVR in our state-of-the-art hybrid operating room. During the procedure, a catheter is inserted either into the patients’ groin, or directly into the lower part of their heart muscle, and a balloon-expandable aortic valve is positioned and deployed within their existing valve, helping expand the passageway. After the procedure, which requires a short hospital stay, most patients feel the immediate benefit of improved blood flow.

For more information about the TAVR procedure, call 310-517-4790

Balloon valvuloplasty (also called percutaneous balloon valvuloplasty) is a procedure that can be used to open up a narrowed (or “stenotic”) heart valve that has been damaged by age or disease (calcification). Balloon valvuloplasty is an interventional cardiology procedure, using ballon catheter technology that typically involves an overnight hospital stay.

With balloon valvuloplasty, a catheter that has a deflated balloon-like device at its tip, is threaded into an artery or vein in the groin and sent to the site of the valve that isn’t functioning properly. Once there, the balloon is inflated to open the valve. When this has been done and the physician is satisfied that sufficient blood flow has been restored, the balloon is deflated and the catheter is removed.

An innovative new treatment, called MitraClip, uses catheter based technology for minimally invasive mitral valve repair. Percutaneous MitraClip placement is used to treat patients with a common heart valve problem called mitral regurgitation (MR). MR is what occurs when a damaged mitral valve allows blood to leak back into the left atrium from the left ventricle of the heart with each contraction.

In a percutaneous MitraClip placement procedure, a catheter is advance from a large vein in the groin to the right atrium, then across the septum into the left atrium after making a small hold in the septum, and positioned across the damaged mitral valve. The catheter is equipped with a clip-like device, called MitraClip. The clip is precisely positioned to repair the valve so it can close properly and reduce the amount of blood regurgitating in the left atrium. This minimally invasive procedure usually requires a one-night hospital stay.

Some people are born with a defect (essentially, a hole) between chambers of the heart. This is called atrial septal defect (ASD), ventrical septal defect (VSD) or patent foramen ovale (PFO) depending on the location. Often these defects can be repaired with an interventional cardiology procedure, using catheter-based technology. These interventional cardiology procedures are done via a catheter that is equipped with a repair device, inserted via a large vein in the groin and advanced to the site of the defect. There are several types of repair devices but most operate like an umbrella; they remain tightly folded until positioned properly and then the device is opened in a way that blocks the hole. It is left permanently in place.

These minimally invasive procedures offer the advantages of easier and quicker recovery, less bleeding and discomfort and faster healing than open-heart surgery.

Our hearts have a small, ear-shaped sac (an “appendage”) in the muscle wall of the left atria (top left chamber of the heart). The purpose of this appendage is not well understood but what doctors do know is that people who have a condition called atrial fibrillation are at risk for a blood clot (stroke) originating from this site. Since the left atrial appendage serves no real function, a procedure called Left Atrial Appendage Closure has been developed to seal off this part of the heart so clots won’t develop or dislodge and travel to the brain. Left Atrial Appendage Closure may be an option for patients with atrial fibrillation who are not good candidates for blood-thinning drugs, which are the first line of treatment for patients at risk for stroke.

The Left Atrial Appendage Closure procedure is done with a new device called the Watchman (from Boston Scientific).

A coronary artery fistula is an abnormal connection (like a tube) between a coronary artery and a heart chamber or other blood vessel. (Sometimes there are several “fistulae.”) Coronary artery fistula is rare but in certain situations it can cause problems. It may then requires treatment to sever the connection so it cannot divert blood flow.

Most patients with coronary fistula require surgical treatment but some, who are not good candidates for traditional open-heart surgery, can be treated with catheter-based technology.

Paravalvular leak (an incomplete seal at the site of a replacement heart valve) is a not-uncommon potential complication of heart valve surgery. Some paravalvular leaks are mild and can be monitored and handled without need for an additional procedure. If repair is required, it can often be done via a minimally invasive, catheter-based procedure.