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Transcatheter Therapies

The Transcatheter Therapies Program at Palm Beach Gardens Medical Center provides a highly-personalized, innovative approach to treating heart valve disease and structural heart conditions.

Open-heart surgery is not the only treatment route when it comes to heart disease. Many defects can now be repaired percutaneously via catheter, instead of through open-heart surgery.

Upon receiving a structural heart or valve disease diagnosis, you may be faced with difficult decisions. Palm Beach Gardens Medical Center is here to ease your mind and help find the best treatment option to fit your needs.

ASD/PFO Closure

An Atrial Septal Defect (ASD) is described as having a hole in the hearts septum. The septum is a membranous wall that runs between the right and left sides of the heart. This defect is hereditary and if left untreated, a substantial mixing of oxygenated and non-oxygenated blood may occur. Symptoms include shortness of breath, fainting, irregular heart rhythms or fatigue after mild activity or exercise. In some instances, a stroke may be the first warning sign of the defect.

A Patent Foreman Ovale (PFO) is described as a small opening between the upper chambers of the heart. A PFO may potentially allow hazardous clots to enter from the right side of the heart to the left and travel to the brain, ultimately causing a stroke.

Patients with ASD/PFOs, history of strokes or evidence of heart failure are often eligible for percutaneous closure. We have many closure devices available for such patients. Typically these procedures are performed with conscious sedation and no need for general anesthesia or TEE. Patients are usually discharged home the next day.  

MitraClip

(Transcatheter Mitral Valve Repair or TMVR)

The MitraClip is a fairly new device designed to repair mitral regurgitation, a disorder of the mitral valve of the heart that prevents it from closing properly, in a less invasive way than previously available surgical options.

Mitral regurgitation is the most common type of heart valve disorder. The mitral valve, located between your heart’s two left chambers, has two flaps of tissue called leaflets. These leaflets open and close to keep your blood flowing in one direction. When the mitral valve doesn't close all the way, blood that is supposed to flow into the upper chamber of the heart leaks back into the lower chamber. When this happens, less blood flows throughout your body, and may make your heart work harder leading to the potential for serious heart complications.

How It Works

Transcatheter Mitral Valve Repair (TMVR) using MitraClip may be an option for you if your doctor determines you are too high risk for open-heart surgery to repair mitral regurgitation. TMVR is a less invasive procedure where the MitraClip device is inserted by a catheter through a vein in your leg and guided to your heart. The device is a small clip that is attached to your mitral valve and allows it to close like it should and restore normal blood flow through your heart.

What to Expect

Although it’s still a new procedure, we have learned from following patients closely that it may provide immediate relief of symptoms caused by mitral regurgitation. You will probably have a hospital stay of two to three days, and you should be back on your feet and experience an improved quality of life soon after you return home.

However, TMVR is not right for everyone. For some, the risks of the procedure may outweigh the benefits. Our team of leaders here at The Heart & Vascular Institute at Palm Beach Gardens will discuss all of the risks and benefits with you.  

Percutaneous Ventricular Assist Device (VAD)

A Ventricular Assist Device (VAD) supports the heart by assisting the ventricles in pumping blood. Ultimately, this is designed to ease the strain on the heart in patients with heart failure. Patients who are enduring high risk angioplasty as well as patients who have acute myocardial infarction (heart attack) may receive Percutaneous Ventricular Assist Devices to strengthen the heart while it heals.

PVL Closure

Percutaneous Transcatheter Paravalvular Leak Closure is now a treatment option for patients who develop leaks around prosthetic heart valves. These patients frequently present with severe symptoms of heart failure and/or hemolytic anemia. The procedure uses several types of vascular plugs which can be implanted via an artery or vein in the leg and patients are normally discharged within the following two days.

Transcatheter Aortic Valve Replacement (TAVR)

This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place. The surgery may be called a transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI). 

Somewhat similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.

How is TAVR or TAVI different from the standard valve replacement?

This procedure is fairly new and is FDA approved for people with symptomatic aortic stenosis who are considered a high-risk patient for standard valve replacement surgery. The differences in the two procedures are significant.

What is involved in a TAVR procedure?

Usually valve replacement requires an open-heart procedure with a “sternotomy,” in which the chest is surgically separated (open) for the procedure. The TAVR procedure can be done through very small openings that leave all the chest bones in place. 

TAVR provides a beneficial treatment option to people who may not be candidates for traditional surgical intervention. A patient's experience with a TAVR procedure may be comparable to a balloon treatment or even an angiogramin in terms of down time and recovery, and may require a shorter hospital stay (average 3-5 days).

The TAVR procedure is performed using one of two different approaches, allowing the cardiologist or surgeon to choose which one provides the best and safest way to access the valve:

  • Entering through the femoral artery (large artery in the groin), called the transfemoral approach, which does not require a surgical incision in the chest
  • Using a minimally invasive surgical approach with a small incision in the chest and entering through a large artery in the chest or through the tip of the left ventricle (the apex), which is known as the transapical approach

WATCHMAN™

WATCHMAN™ is an innovative implant device intended to reduce your risk of stroke. Patients who are affected by AFib have a five times greater risk of stroke and are normally required to take a long-term blood thinning drug which comes with potentially severe side effects. The WATCHMAN™ implant is designed to act as an obstruction, preventing left atrial appendage blood clots from entering the bloodstream and blocking a blood vessel. With the advancements of WATCHMAN™, patients may be able to discontinue their use of long-term blood thinner medications.

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