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Innovation in Minimally Invasive Cardiac Procedures

By Govind Ramadurai, MD

The growth seen in healthcare technology is at an all-time high, specifically for advanced imaging techniques which can help diagnose health conditions accurately. When dealing with medical conditions related to your cardiac system, it is important to have precise testing that can identify your diagnosis early, as heart failure and other cardiac diseases continue to lead the mortality rate for both men and women in the United States.

With precise imaging, your cardiologist is able to create an informed treatment plan that best suits your condition. If your heart condition is chronic or you have heart failure, open heart surgery or long-term medication might be your next step. However, many cardiologists now have the ability to offer minimally invasive procedures that can be just as effective as open heart surgery, without the higher risk.

Our structural heart team offers the following minimally invasive procedures that may be used as an alternative to open heart surgery.

MitraClip®

Mitral regurgitation occurs when the mitral valve in your heart doesn’t close properly, allowing backward blood flow. Some common symptoms may be persistent or worsening fatigue, shortness of breath or swelling and fluid buildup in your feet, ankles and lungs. If left untreated, mitral regurgitation can lead to high blood pressure (pulmonary hypertension). In the past, this condition has been treated through open heart surgery, however, our structural heart team is now able to offer a less invasive procedure called MitraClip®.

The MitraClip® allows your cardiologist to repair the malfunction in the mitral valve, without opening the chest, by accessing the valve through a thin tube that is inserted in a vein to reach your heart. The MitraClip® will then permanently attach to the valve which will aid in regaining regular blood flow to the heart. The procedure time varies by case and you are typically released from the hospital one to three days after your procedure.

Micra™ Wireless Pacemaker

If you have chronic atrial fibrillation (AFib), heart failure or a slow heart beat or are taking long-term medications that may affect your heart, your doctor may recommend a pacemaker to monitor and prevent further cardiac complications.

The Micra™ device is one of the smallest pacemakers in healthcare and is inserted directly into your heart through one minimally invasive attempt. The device is placed on a tube that is inserted through your vein and guided to your heart, leaving you with no scar or bump. Once inserted, the Mirca™ pacemaker is able to adjust your heart rate automatically by sensing changes in your body and has a battery life of twelve years. This is a significant advancement in heart monitoring as seen from previous pacemakers, which are placed in your chest with leads running to the heart and frequent maintenance visits.

Valve Closures

Our structural heart team can use transcatheter valve repair devices to address several different heart conditions. In each of the following procedures, a small incision is made in your groin, leg, upper stomach or neck for insertion of a thin, flexible tube that will be guided to your heart and used to place the plug or patch device in the proper area for valve closure.

Atrial Septal Defect Closure (ASD)

ASD is a hole between the two upper chambers of the heart. Symptoms may include decrease in exercise capability, fatigue, heart palpitations and shortness of breath. If left untreated, ASD can put you at higher risk for excessive blood flow to the right side of your heart and increased pressure in your pulmonary artery. ASD closure is performed with a guided catheter that places a patch over the hole between your heart chambers. The procedure takes approximately one to two hours and the length of the hospital stay varies from patient to patient.

Patent Foramen Ovale Closure (PFO)

PFO is an intracardiac condition that occurs at birth when the heart doesn’t fully close, resulting in a hole. The most common symptoms are an irregular heartbeat and shortness of breath. If left untreated, you may be at higher risk of developing a blood clot. PFO closure takes approximately two hours to complete and consists of a catheter and closure device being inserted through a vein, where the device will be placed to straddle each side of the heart hole. From there, the device will permanently remain in your heart to stop abnormal blood flow between the two atrial chambers of your heart.

Transcatheter aortic valve replacement (TAVR)

Aortic stenosis occurs when the aortic valve begins to narrow, reducing blood flow from your heart to the rest of your body, causing chest pain, heart murmurs and shortness of breath. Aortic stenosis weakens your heart over time putting you at higher risk for further cardiac complications. In some cases, aortic valve replacement surgery is necessary, but in others, a less-invasive procedure called TAVR is an option. During this procedure, a heart valve device is placed on your diseased or failing valve to act as a replacement valve that will aid in proper blood flow. The procedure is approximately one to two hours long and you might spend up to two days in the hospital, depending on your condition.

WATCHMAN™

Atrial Fibrillation (A-FIB) is one of the most common types of abnormal heart rhythms and may produce a variety of symptoms including shortness of breath, fatigue and chest pain. Long term, AFib can increase your risk of stroke or developing additional disorders that affect your heart's rhythm.

If you have chronic A-FIB, the WATCHMAN™ procedure provides you with an alternative treatment option to long-term anticoagulation medication, or blood thinners, through a one-time, minimally invasive procedure. During this hour-long procedure, your cardiologist will implant the WATCHMAN™ device through a catheter into the left atrial appendage (LAA), the small ear-shaped sac in the muscle wall of the let atrium of your heart. The WATCHMAN™ closes the LAA to keep blood clots from forming in this area. Most patients return home the next day following the procedure.

As the cardiology field continues to advance in imaging, cardiac procedures and research, more access is available for informed decision-making and preventive heart health practices. By using these methods, we are able to ensure the highest quality images, better clinical answers and more effective treatment plans for our patients.

For a full list of our cardiology services, please visit our cardiology page. You can also schedule an appointment with a cardiologist online, or by calling your preferred location.


Topics and Subtopics: Heart Health

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