Structural Heart and Valve Center
Advanced Treatments and Services
The specialists at the Emory Healthcare Structural Heart and Valve Center have more than two decades of experience performing minimally invasive procedures on the heart and heart valves. As a nationally recognized academic center, Emory has access to FDA approved transcatheter valve replacement as well as up and coming clinical trial treatments when applicable.
Emory is also known for our innovative catheter-based techniques for replacing previously placed surgical valves that are now malfunctioning, as well as our state-of-the-art techniques for addressing congenital (present at birth) heart defects.
Learn more about the treatments we offer below.
Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive treatment option for patients with severe aortic stenosis (narrowing of the aortic valve). Emory experts have been offering TAVR since 2007, and have performed this treatment successfully on over 1,500 patients, more than any other provider in the Southeast.
During TAVR, Interventional Cardiologists and Cardiothoracic Surgeons work together to replace the aortic valve with catheters through small incisions either in the groin or chest. This technique is performed without opening the chest as in traditional open heart surgery. This minimally invasive approach allows patients to recover more quickly than open chest procedures, reduces the risk of surgical complications, and allows patients to go home sooner than the traditional surgery.
Initially used to treat patients deemed too high-risk for open heart surgery, TAVR has recently been shown to be highly effective in treating medium-risk patients. Emory is a nationally recognized academic center of excellence and offers a vast array of novel technologies and treatment options through FDA approved transcatheter therapies as well as clinical trials. Emory is now offering TAVR to patients of low surgical risk within the PARTNER III clinical trial.
Listen to Dr. Thourani, co-director of the Emory Structural Heart and Valve Center and a co-investigator for the PARTNER II Trial, discusses the biggest news item from American College of Cardiology Scientific Session 2016 — the Sapien 3 TAVR device performed better than surgical aortic valve replacement.
Balloon valvuloplasty is a minimally invasive treatment option for patients with degenerative valve disease (deterioration of the heart valves). Many patients with this condition are ineligible for traditional open heart surgery because of their high-risk status (e.g., advanced age, multiple chronic conditions or end-stage disease).
During balloon valvuloplasty, the surgeon will make a small incision and insert a catheter (thin, flexible tube) with a small, deflated balloon attached to the tip and thread it through a blood vessel. Once the catheter reaches the damaged valve, the balloon is inflated to stretch the valve opening and allow more blood to flow through it. The balloon is then deflated and guided back out through the vessel and removed. The small incision is then stitched up.
The patient is generally awake during this procedure, and recovery time is considerably shorter than traditional surgery. However, balloon valvuloplasty is not a permanent solution and often has to be repeated at a later date.
Percutaneous Mitral Valve Clip Placement
Percutaneous mitral valve clip placement is a minimally invasive treatment option for patients with a leak in the mitral valve.During this procedure, the surgeons make a small incision through which a catheter (thin, flexible tube) is inserted to deliver a small clip into the heart via the femoral vein (located in the upper thigh). Once in place, the clip is attached to the leaflets (“swinging doors”) of the mitral valve to improve their function, and the catheter is removed. Because the procedure is minimally invasive, the recovery time is substantially shorter than with traditional open heart surgery.
At the Emory Heart and Valve Center, our experts have successfully implanted more than 100 FDA-approved MitraClips to patients with mitral valve regurgitation.
People born with small holes in their heart have either a septal defect or patent foramen ovale (PFO). Traditionally, these patients may have faced a lifetime of anticoagulant therapy or open heart surgery in order to repair the hole and reduce the high risk of stroke. Emory now offers a minimally invasive option for these patients.
During the procedure, the surgeon makes a small incision and inserts a hollow catheter (thin, flexible tube) to be threaded through a blood vessel and guided to the site of the defect. Once in place, it is used to deliver a collapsed mesh closure device to be placed inside the defect. The device is then activated, expanding to block the hole and hold the device in place. The catheter is then removed and the incision stitched up. Recovery time following this procedure is considerably shorter compared to traditional surgery.
Left Atrial Appendage (LAA) Closure
The left atrial appendage (LAA) is a small pouch on the left side of the heart. Patients with atrial fibrillation (abnormal heart rhythm) have a high risk of blood clots forming in the LAA. These clots can dislodge from the LAA and block blood flow to crucial parts of the body, including the brain (stroke). Oral anticoagulation medications may be used to reduce the risk of clots, but these medications are not safe or appropriate in some patients. In such cases, LAA closure is a viable minimally invasive treatment option.
During LAA closure, a small incision is made, and a catheter (thin, flexible tube) is inserted and used to deliver a closure device to the left side of the heart. There, the device is inserted into the LAA and expanded like an umbrella to seal off the entrance to the pouch. The catheter is then removed and the incision is stitched up.
Coronary Fistula Closure
A coronary fistula is an abnormal connection between a coronary artery and a heart chamber or another blood vessel. A fistula generally needs to be repaired in order for the heart to function properly, unless it is very small. Emory offers a minimally invasive procedure for those with a coronary fistula.
During the procedure, the surgeon makes a small incision and a catheter is inserted and advanced through a vein to the site of the fistula. Then, a wire coil is placed to block the abnormal opening. The catheter is removed and the incision is stitched up.
Pulmonary Vein and Artery Stenting
This minimally invasive procedure is used to open up a pulmonary blood vessel (carries blood to and from the lungs) that may have narrowed for a variety of reasons. During the procedure, a small incision is made and a stent (small mesh tube) is placed over a tiny deflated balloon and delivered to the narrowed portion of the vessel using a catheter (thin, flexible tube) fed through a vein. Once in place, the balloon is inflated, thereby expanding the stent and anchoring it in place. The balloon and catheter are then removed and the incision is stitched up.
Repeating surgery to repair a leaking prosthetic (replacement) heart valve is a very risky procedure for some patients. Emory offers a minimally invasive technique for patients who need to repair a previously replaced heart valve. During the procedure, a small incision is made and a catheter (thin, flexible tube) is inserted to deliver and deploy a closure device at the site of the leak. Once in place, the catheter is removed and the incision is stitched up.
The left side of the heart is difficult to access during heart procedures due to the natural anatomy of the heart. Due to this roadblock, Emory offers minimally invasive transseptal puncture. This technique creates a small surgical passage through the atrial septum (wall between the right and left sides of the heart) through which a catheter (thin, flexible tube) can be directly fed. The puncture hole generally heals on its own following the procedure.
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