Valvular Hearth Disease

The heart is a muscle which pumps blood to your lungs and around the body. There are four valves within the heart. These valves normally open
to let blood ow through, or out, of the heart, and then shut to prevent blood owing backwards.

If a valve becomes diseased or damaged this can affect the ow of blood in two ways: 1. If the valve does not open fully it will obstruct the ow. This is called valve stenosis. 2. If the valve does not close properly it will allow blood to ow backwards in the wrong direction. This is called valve regurgitation.

AORTIC VALVE STENOSIS. TRASCATHETER AORTIC VALVE REPLACEMENT

The aortic valve is on the left side of the heart. When the valve opens blood is normally pumped from the left pumping chamber of the heart (ventricle) around the body. When the aortic valve is narrowed the blood flow out of the heart is restricted. This can cause symptoms of chest pain, breathlessness and/or dizziness when exercising, and can lead to fainting. The restriction may also put a strain onto your heart pump, leading to heart muscle weakness, fluid on the lungs or swollen ankles.

The preferred treatment for severe symptomatic aortic valve stenosis is conventional aortic valve replacement. This involves open-heart surgery to replace the narrowed valve with a new articial one.  However, currently a less invasive procedure has been developed to replace the valve with the TAVR technique (Transcatheter Aortic Valve Replacement) .

TAVR involves inserting a new artificial heart valve inside the old tight valve using a catheter through the femoral artery (artery in the groin). The implanted valve is of the same type of the biologic prosthesis that are surgically implanted and this technology presents the main advantage of an early recovery and a shorter in-hospital stay.

To determine whether you are eligible for this technology you will require a complete evaluation by our medical team with a blood test, echocardiography and cardiac CT.

MITRAL REGURGITATION. MITRACLIP THERAPY

The mitral valve is on the left side of your heart and controls blood flow from the atrium to the ventricle. This valve has two leaflets that open and close to ensure blood travels in only one direction within the heart.  In people with mitral regurgitation, the mitral valve doesn’t seal completely and blood leaks backward. As a result, the heart must work harder to push blood through the body. Common symptoms caused by this increased workload include fatigue, shortness of breath, coughing, an irregular heartbeat and worsening heart failure. MR is a progressive disease that can eventually impact your quality of life and make daily activities more difficult.

The goal of treatment is to decrease the mitral regurgitation and improve your quality of life. Medications may be prescribed to help reduce the symptoms you experience, but they cannot fix the valve itself. The current gold standard for treating a severely leaking mitral valve is to perform open heart surgery. The purpose of surgery is to either replace the valve with an artificial one (mitral valve replacement) or repair the existing mitral valve. In open heart surgery, a heart-lung machine is used to take over the role of your heart while it is being worked on. Over the past few years, the MitraClip device has been used in many patients to correct blood flow through the mitral valve without open heart surgery (VIDEO 2). The MitraClip procedure is done by use of a catheter that is inserted through a needle hole (percutaneously, or via the skin) in the groin. The catheter—a long, flexible tube—is inserted into a large vein in your groin (femoral vein) and guided to your heart. Through the catheter, the Mitraclip is inserted and positioned by ultrasound to the leaking portions of the valve. The clip is attached to the mitral valve leaflets, fastening them firmly together and allowing the valve to close better. The advantage of this procedure is that it is less invasive than open heart surgery and may reduce the amount of complications and recovery time. In addition, the Mitraclip implant does not restrict, if necessary, a valve replacement in the future.

To determine whether you are eligible for this technology you will require a complete evaluation by our medical team with a blood test and a transesophageal echocardiography.

PERIVALVULAR LEAKS. THERAPY WITH ENDOVASCULAR DEVICES

Perivalvular leaks may occur in patients who have undergone undergone a complete valve replacement. They are usually due to the presence of a friable tissue that causes some loosening of the stiches that led to a hole beside the valve where the blood regurgitates. Common symptoms caused by perivalvular leaks include shortness of breath (dyspnea), anemia (due to the destruction of red cells through the leak), or even both.

The treatment of these leaks consists in correcting them by a new operation in which the leakage is well sutured or valve is completely replaced again. This new reintervention has a greater surgical risk than the first surgery. Currently a percutaneous procedure can be done to seal the leaks. Using a catheter through a vein or an artery different plugs can be implanted to reduce the size of the leak. The result obtained by this minimally invasive technique is comparable to surgery and allows a much earlier recovery of the patient.

To determine whether you are eligible for this technology you will require a complete evaluation by our medical team with a blood test and a transesophageal echocardiography.