At Penn Medicine, we use a wide range of minimally invasive, advanced procedures to treat structural heart diseases. Our renowned team of interventional cardiologists uses state-of-the-art tools to correct structural heart problems and increase heart function.
What is Structural Heart Disease?
Structural heart diseases are conditions that affect your heart muscle, walls, chambers or valves. Some of these conditions are present at birth (congenital), or they may develop over time. Without treatment, structural heart diseases can force your heart to work harder to pump blood throughout your body, eventually leading to heart weakening and damage.
Structural Heart Procedures and Treatments We Offer
Many structural heart disease treatments are designed to improve your heart's function. These procedures may open narrowed heart valves, close holes in your heart or replace damaged valves. In the past, performing these procedures required open-heart surgery, with a long incision through the chest and breastbone to access the heart.
Thanks to new technologies, we can now use a minimally invasive approach to structural heart disease treatment that avoids opening the chest and breastbone. Instead, an interventional cardiologist uses a flexible, hollow tube (catheter) to access the heart through a blood vessel in the groin. These interventional techniques offer benefits including:
- Faster recovery
- Less pain
- Lower risk of complications
- Shorter hospital stays
Your treatment team chooses the best approach for you based on your overall health and risk factors. Older people and those with underlying health conditions may not be good candidates for open-heart surgery. With interventional cardiology, we can provide structural heart disease treatment options for these people.
Our interventional cardiologists offer the full range of structural heart disease treatments including:
Conditions Treated with Structural Heart Procedures
Some structural heart diseases are diagnosed before or at birth, while others are acquired later in life. Adults with structural heart problems may not experience any symptoms in the early stages of the disease. These conditions may go undiagnosed until symptoms worsen.
As structural heart diseases progress, you may experience symptoms such as:
- Arrhythmias (irregular heart rhythms)
- Chest pain
- Fatigue
- Lightheadedness or dizziness
- Shortness of breath
- Swelling in your feet, ankles or abdomen
Structural heart diseases can also run in families, so it's important to tell your provider if you have a family history of any of these conditions. If you have a structural heart disease, your family members may also need tests to look for these illnesses early. Your provider may order tests that evaluate the heart's structure and function to look for signs of structural heart disease, including:
- Chest X-ray to look at your heart's shape
- Echocardiogram to evaluate your heart's structure and blood flow
- Electrocardiogram to assess your heart's electrical activity
- Cardiac catheterization to look for narrowed or blocked blood vessels
We treat an extensive array of structural heart diseases, including:
- Aortic valve stenosis: This type of aortic valve disease occurs when the aortic valve between the lower left heart chamber (ventricle) and the aorta, narrows and restricts blood flow to the aorta and the body.
- Aortic regurgitation: If the aortic valve doesn't close tightly, blood leaks backward from the aorta to the left ventricle. The leaking forces the heart to work even harder, which can eventually lead to heart failure.
- Atrial septal defect (ASD): ASD occurs when part of the septum, the tissue that separates the upper two heart chambers (atria), doesn't form properly. The result is a hole in the septum that never closes properly and may not be diagnosed until later in life.
- Cardiomyopathy: This condition occurs when the heart muscles become thickened or enlarged, making it harder for the heart to pump blood throughout the body.
- Mitral stenosis: The mitral valve between the left ventricle and the left atrium narrows and blood flow to the left ventricle, the heart's main pumping chamber, is restricted. It usually results from rheumatic fever in childhood.
- Mitral valve regurgitation: The mitral valve doesn't close properly, causing blood to leak backward into the left atrium. This can reduce blood flow to the rest of the body, causing fatigue, shortness of breath, palpitations or irregular heartbeats.
- Patent foramen ovale (PFO): The small hole between the upper two heart chambers doesn't close as it should before birth and can lead to stroke. PFOs can be closed without surgery.
- Pulmonary stenosis: The pulmonary valve, which controls blood flow from the right ventricle to the pulmonary arteries, narrows. This can block or slow blood flow to the pulmonary arteries, which carry blood to the lungs.
- Pulmonary valve regurgitation: The pulmonary valve doesn't close properly, and blood flows backward into the right ventricle. Most people don't experience symptoms in early stages. Over time, pulmonary regurgitation can lead to heart failure.
- Tricuspid valve regurgitation: The tricuspid valve, which controls blood flow between the right atrium and right ventricle, doesn't close properly. Blood leaks backward into the right atrium, leading to swelling and damage to other organs.
Structural Heart Program: The Penn Medicine Advantage
Specialists in the Penn Interventional Cardiology Program are leaders in structural heart procedures. We have a long history of pioneering innovation and led many of the first clinical trials for treatments that are now standard nationwide. When you choose our team for structural heart disease treatment, you'll benefit from:
- Exclusive treatments: We offer several treatment options not available elsewhere in the region, including emerging structural heart procedures only available through clinical trials. Our physicians are leading trials to treat tricuspid and mitral valve leaking (regurgitation) with a clip or transcatheter valve replacement. We also offer options to treat atrial septal defects (ASDs) with a small, mesh tube (stent) instead of a traditional closure device.
- History of innovation: We were among the first in the nation to offer treatments including transcatheter aortic valve replacement (TAVR), balloon valvuloplasty for mitral stenosis and MitraClip™. Our interventional cardiologists have participated in clinical trials for decades, performing common procedures years before they're approved.
- Excellent outcomes: Our results are among the best in the country. We have the highest ratings for TAVR in the Transcatheter Valve Therapy Registry, a national outcomes database from the Society of Thoracic Surgeons and the American College of Cardiology.
- Deep experience: We are among the top five centers in the United States in TAVR volumes, performing nearly 600 TAVR procedures each year. Our experience with patent foramen ovale (PFO) closure dates back over 20 years, and we are the largest referral center for PFO in the Philadelphia region. These high volumes position our physicians as some of the most experienced in the region and the nation.
- State-of-the-art technology: You receive treatment in our state-of-the-art imaging and catheterization laboratory (cath lab). The cath lab has several hybrid operating rooms where we partner with specialists in the Heart Surgery Program and the Penn Vascular Surgery and Endovascular Therapy Program to offer even more advanced procedures. Our interventional imaging specialists are highly skilled in a range of imaging techniques that allow us to treat the heart with exceptional visualization and precision.
- Comprehensive, team-based care: Interventional cardiologists collaborate with others specialists, including interventional echocardiographers, cardiac surgeons, vascular surgeons and the Heart Valve Disease Program to bring you the best possible care.
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