Treatments and Procedures
Treatments and Procedures
- Your heart deserves quality care, and our board certified physicians at Palm Beach Gardens Medical Center, Delray Medical Center, and Palmetto General Hospital are specially trained to perform valve procedures to replace or repair the aortic and mitral valves. Our team approach speeds up the process of evaluating the problem from weeks or months down to just one day.
- When you visit our valve clinic, your appointment will have a number of steps. First, you will receive an evaluation by the interventional cardiologist and the cardiovascular surgeon where you’ll review together your prior diagnostic studies. If there is any additional testing required, such as an echocardiogram or CT scan, we complete it at this time.
- Once all testing has been performed, your doctors will take your individual characteristics into account and work together to determine the most effective approach for your care. We promise to work closely with your personal cardiologist to ensure a smooth transition back into their care once your treatment with us is over.
- If your doctor determines medication is the best treatment, keep in mind that medication will not cure the disease, but it is quite successful in treating the symptoms. You may be prescribed beta-blockers, digoxin or calcium channel blockers, which reduce the symptoms by controlling the heart rate and atrial fibrillation. In some cases, your doctor may prescribe medications to control blood pressure, such as diuretics or vasodilators.
- In some cases, surgical valve repair or replacement is the best option. When repairing a heart valve your surgeon may cut scarred flaps so the valve opens more easily, remodel enlarged valve tissue or insert prosthetic rings to narrow dilated valves. For valve replacement, your surgeon will use either a tissue valve (a valve from either an animal or human) or a mechanical valve (a valve constructed from an artificial material such as metal or plastic).
Minimally Invasive Valve Surgery
Minimally invasive surgical procedures are allowing doctors to replace or repair heart valves using smaller incisions. These surgeries include the following:
- Laparoscopy requires two- to three-inch incisions in the side of the chest between the ribs. Special instruments, including one with a fiber-optic camera, are inserted through these incisions, allowing the doctor to work on the heart.
- Robotic surgery requires between two and four incisions that are no more than three-quarters of an inch long. The surgeon uses a computer-controlled robot to manipulate the surgical instruments.
- Endoscopic or keyhole surgery uses one to four incisions in your chest for the instruments to be inserted.
A heart-lung machine may not be needed for minimally invasive surgery. Instead, your doctor will use medications or a mechanical device to slow your heart rate enough for the surgery.
The benefits of minimally invasive heart valve surgery may include:
Less bleeding during the surgery, which minimizes the need for blood transfusions
Lower infection risks
Smaller incisions and scars
Shorter hospital stay
Faster recovery time
Transcatheter therapies can offer patients that are suffering from severe aortic and mitral valve disease, new options for treatment. Transcatheter therapies are minimally invasive techniques that allow the surgeon to repair or treat the heart, or areas surrounding the heart, which may help patients at high risk of morbidity and mortality with open heart surgery. An incision in the groin is made to insert a catheter into the vein to reach the affected area. This allows the surgeon to treat or repair the damage.
Transcatheter Aortic Valve Replacement (TAVR) –Traditionally, repair or replacement of heart valves has involved open-heart surgery but for some patients traditional treatments may not be an option. Transcatheter aortic valve replacement, or TAVR, is an advanced minimally invasive alternative treatment option for some cases of aortic valve stenosis.
- Percutaneous Repair of the Mitral Valve (Mitraclip) – Mitral regurgitation is a debilitating, progressive and life-threatening disease in which a leaky mitral valve causes a backward flow of blood into the heart. Medications for mitral regurgitation only assist with symptom management and do not stop the progression of the disease. The MitraClip device is a minimally invasive transcatheter therapy to repair the mitral valve, rather than replacing it which typically involves open heart mitral valve surgery.
- WATCHMAN Left Atrial Appendage Closure Device – When a bold clot develops in the heart of a patient with atrial fibrillation, it is most often found within the left atrial appendage. The left atrial appendage is a small pouch that empties blood into the atrium, one of the upper chambers of the heart, by pumping with the rest of the left atrium. When the left appendage does not pump regularly, the blood in the pouch can form clots which may be pumped out and can travel to the brain, which could cause a stroke.
The WATCHMAN Device which acts as a barrier to prevent blood clots from entering the bloodstream. The closure prevents harmful blood clots, due to AFib, from entering the blood stream and potentially causing a stroke.
AFib patients have a five times greater risk of stroke and typically have to take a long-term blood-thinning drug with potentially serious side effects. After a successful procedure, patients will be able to stop taking the blood-thinning drug.
- Abdominal Aortic and Thoracic Aneurysm Endograft Treatments – The abdominal and thoracic aortic aneurysm endograft is developed to treat patients who have a bulge caused by the weakening of the walls of the aorta. Endograft repairs are a minimally invasive approach that inserts a stent graft, a mesh tube, to reinforce the area weakened by the aneurysm, often shrinking the bulge and preventing the aneurysm from bursting.
- Percutaneous Ventricular Assist Device – A ventricular assist device (VAD) is a mechanical device used to take over the pumping function for one or both of the heart’s ventricles, or pumping chambers. A VAD may be necessary when heart failure progresses to the point that medications and other treatments are no longer effective. Percutaneous Ventricular Assist Devices are used in patients undergoing high risk angioplasty and also in patients who have acute myocardial infarction, heart attack, to support the heart and allow the heart to heal.