Patients with structural heart disease benefit from minimally invasive, collaborative approach

Norton Heart & Vascular Institute has been treating structural heart conditions for more than 10 years and adopted the multiprovider approach more recently to support patients through diagnosis, treatment and recovery.

With age, injury and even infection, the structure of your heart can change. Sometimes, these changes affect valves that either don’t let enough blood pass or leak when the powerful muscle of the heart contracts, sending blood backward.

It’s a complicated issue, and unlike other heart conditions, isn’t caused by diet, smoking or even genetics.

Patients with structural heart conditions typically need the care of multiple heart specialists who can collaborate from their own viewpoints to arrive at a comprehensive care plan. Combining the skills of cardiothoracic surgeons, interventional cardiologists, electrophysiologists and imaging cardiologists into the same team brings more experience to bear and a more convenient treatment path for the patient.

“Patients are fast-tracked for evaluation, diagnosis and treatment, and those who need surgery or minimally invasive procedures are scheduled within four weeks,” said D. Sean Stewart, M.D., structural heart disease and interventional cardiologist with the Norton Heart & Vascular Institute Structural Heart Program.

Patients can schedule multiple appointments in one visit on the Norton Audubon Hospital campus. A nurse navigator can assist patients in finding their way through their care, with help ranging from explanations about the patient’s condition and care to navigating insurance, planning aftercare and any home-care needs.

Norton Heart & Vascular Institute has been treating structural heart conditions for more than 10 years and adopted the multiprovider approach more recently to support patients through diagnosis, treatment and recovery.

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Understanding structural heart disease

All four of the heart’s valves — aortic, mitral, tricuspid and pulmonic — need to open wide, then shut tight in a precise rhythm for blood to keep moving forward to the lungs and out to the rest of the body.

“Heart valves may not close all the way — regurgitation — or open sufficiently —  stenosis. These conditions can develop over time and often don’t need treatment. Sometimes invasive treatment is necessary to fix these issues. In these instances, if left untreated, structural heart disease can lead to serious complications,” Dr. Stewart said.

The mitral valve is particularly prone to begin to leak over time. As it regulates the blood flow into the heart’s powerful left ventricle, this leakage can lead to serious and even life-threatening issues.

If left untreated, mitral regurgitation can lead to heart failure and arrhythmia.

Likewise, the aortic valve is prone to become narrow over time. Valve stenosis happens when a valve becomes narrowed or stiff and doesn’t allow enough blood to flow out of the heart to the rest of the body. The result is typically shortness of breath and chest discomfort.

In some instances adults were born with structural heart conditions. They need continuing specialized care throughout their lives from congenital heart defect specialists as children, then adult congenital heart disease specialists as they grow older.

Regardless of the type or cause of the valve issue, the specialists across Norton Heart & Vascular Institute can meet patients’ treatment needs.

Treatment options for structural heart disease

“What was once treated with open heart surgery and required a multiple-day stay in the hospital is now considered minimally invasive. Patients often go home the next day,” Dr. Stewart said.

With the help of the latest technology, structural heart disease specialists use minimally invasive treatments that use tools threaded through blood vessels to the diseased valve to make repairs or even replacements. A tiny incision in the groin or an alternative site allows the physicians to access blood vessels, while advanced imaging helps them guide a catheter to the valve causing the condition.

Structural heart disease treatments include transcatheter aortic valve replacement (TAVR), transcatheter tricuspid valve repair or replacement, transcatheter pulmonic valve replacement, left atrial appendage closure (Watchman) and transcatheter mitral valve repair or replacement.

“Rest assured, the structural heart team at Norton Heart & Vascular Institute has the experience and expertise to treat you and your loved one with these conditions,” Dr. Stewart said.

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