Cardiology

Treatments for Heart Valve Disease

Many individuals with heart valve disease may be told there is no way to treat their valve issues or that the only therapy is open-heart surgery. But the Structural Heart Team at UI Health provides a variety of minimally invasive treatments for heart valve disease. 

Transcatheter Aortic Valve Replacement/TAVR

For certain patients with a damaged aortic valve as a result of aortic stenosis, open-heart valve replacement surgery can be risky, especially if they are older and have other health conditions. These patients once had few other options, but now an alternative exists: transcatheter aortic valve replacement (TAVR) surgery. This procedure involves introducing a new valve without having to remove the old one. 

In TAVR, a catheter is inserted from the groin or neck and extended to the heart, where the valve is. The surgeon sends a collapsible valve through the tube to the aortic valve, where the replacement valve expands. It pushes the old valve's leaflets out of the way and begins opening and closing normally to allow blood to pass.  

All patients with aortic stenosis are candidates for TAVR.

It used to be that only patients who had a very high risk for open-heart surgery were the only candidates for TAVR, but recently, studies have shown that patients at low-risk for surgery also can benefit from TAVR. If you've been told you have a tight heart valve, or that there are no ways to treat your heart-valve issues — TAVR is a therapy for you.

Patients typically are in the hospital for just 36 hours and can return to work within just a few days — compared to up to a week of hospitalization for open heart surgery, in addition to a monthlong recovery at home.  

TAVR can help these individuals live longer — and better. 

MitraClip Procedure

Just like the aortic valve, the heart's mitral valve can get narrowed (stenosis), but more commonly, it gets leaky. The valve's two leaflets do not close properly, and blood flows backward through the valve — this is called mitral valve regurgitation. Patients with mitral valve regurgitation can experience profound shortness of breath; have heart failure symptoms or be diagnosed with heart failure; develop swelling in their legs; and over time cause heart function to get weak.

A less invasive alternative to open-heart surgery, the MitraClip procedure is a catheter-based treatment that involves placing the MitraClip device — a metal clip with a covering of polyester fabric — on a regurgitating mitral valve, the gateway between the heart's left atrium and left ventricle. The MitraClip pins part of the valve together, which allows the rest of the structure to open and close around it and prevents blood from leaking backward. This decreases the amount of blood that moves backward through the valve and into the lungs, which can cause shortness of breath.  

Left Atrial Appendage Occlusion/The Watchman^TM Procedure

Certain individuals with atrial fibrillation, the most common type of abnormal heart rhythm, have an above-average risk for stroke because the irregular pumping of the heart can cause a blood clot to form in the heart's left atrial appendage (LAA), a small structure in the top-left chamber of the heart. If the clot dislodges and travels to an artery that sends blood to the brain, it can cause a stroke.

Cardiologists often prescribe a blood-thinning medication to prevent the formation of blood clots in patients with atrial fibrillation who have an increased risk for stroke, but UI Health offers an alternative: Watchman, a small device that closes the LAA. Using a percutaneous approach, an interventional cardiologist uses a catheter inserted through a vein in the groin to send Watchman to the LAA and seal it. The device is permanent, and most patients taking a blood thinner are able to stop the medication after Watchman is placed.