The Structural Heart and Valve Program at Torrance Memorial Medical Center
builds on our longstanding tradition of excellence. Our
Lundquist Lurie Cardiovascular Institute is ranked among Southern California’s top heart programs. With years
of advanced training in their specialty, our interventional cardiologists
offer expertise derived from treating high volumes of patients with conditions
ranging from routine to complex. Some of the complex procedured include
TAVR, aortic and mitral valve valvuloplasty, and percutaneous (meaning “through
the skin”) closures of patient foramen ovale (PFO), atrial septal
defect (ASD), ventrical septal defect (VSD) and paravalvular leaks resulting
from prior valve replacement surgeries.
Interventional cardiologists work along side cardiac surgeons as part of
the Structural Heart and Valve Disease team, offering comprehensive treatment
options for all cardiac conditions, including complex structural and congenital diseases.
Transcatheter Aortic Valve Replacement (TAVR)
Often lifesaving, the
TAVR procedure vastly improves quality of life for patients with severe aortic
stenosis (hardening of the aortic valve).
What is Aortic Stenosis?
A fairly common complication of aging, aortic stenosis is the medical term
that describes stiffening (due to deterioration and calcification) of
the aortic valve in the heart. Aortic stenosis causes chest pain, dizziness,
shortness of breath and extreme fatigue. Blood doesn’t travel easily
from the heart through the hardened aortic valve, to the rest of the body.
The restricted blood flow caused by aortic stenosis results in high risk
of a heart attack, or even sudden death.
How Does TAVR Work?
Here at Torrance Memorial Medical Center, our interventional cardiologists
and cardiac surgeons on staff have extensive experience performing
TAVR in our state-of-the-art
hybrid operating room. TAVR requires a brief hospital stay, typically one to five nights. Under
light anesthesia, a stent-like catheter carrying a replacement heart valve
is inserted into an artery in the groin or directly into the heart from
the left side of the chest. Upon arrival at the site of the damaged heart
valve, a new bioprosthetic (tissue) valve stent is placed atop the damaged
valve; it remains there after the procedure. TAVR patients get the benefit
of a replacement valve without having to undergo open heart surgery to
remove and replace the malfunctioning one. Many feel better almost immediately
after the TAVR procedure. This minimally invasive alternative to open
heart surgery not only improves quality of life but, for many patients,
it extends it.
Balloon valvuloplasty (also called percutaneous balloon valvuloplasty)
is a procedure that can be used to open up a narrowed (or “stenotic”)
heart valve that has been damaged by age or disease (calcification). Balloon
valvuloplasty is an interventional cardiology procedure, using ballon
catheter technology that typically involves an overnight hospital stay.
With balloon valvuloplasty, a catheter that has a deflated balloon-like
device at its tip, is threaded into an artery or vein in the groin and
sent to the site of the valve that isn’t functioning properly. Once
there, the balloon is inflated to open the valve. When this has been done
and the physician is satisfied that sufficient blood flow has been restored,
the balloon is deflated and the catheter is removed.
Percutaneous Mitral Valve Clip (MitraClip) Placement
An innovative new treatment, called MitraClip, uses catheter based technology
for minimally invasive mitral valve repair. Percutaneous MitraClip placement
is used to treat patients with a common heart valve problem called mitral
regurgitation (MR). MR is what occurs when a damaged mitral valve allows
blood to leak back into the left atrium from the left ventricle of the
heart with each contraction.
In a percutaneous MitraClip placement procedure, a catheter is advance
from a large vein in the groin to the right atrium, then across the septum
into the left atrium after making a small hold in the septum, and positioned
across the damaged mitral valve. The catheter is equipped with a clip-like
device, called MitraClip. The clip is precisely positioned to repair the
valve so it can close properly and reduce the amount of blood regurgitating
in the left atrium. This minimally invasive procedure usually requires
a one-night hospital stay.
Septal Defect and Patent Foramen Ovale Closure (ASD, VSD, PFO)
Some people are born with a defect (essentially, a hole) between chambers
of the heart. This is called atrial septal defect (ASD), ventrical septal
defect (VSD) or patent foramen ovale (PFO) depending on the location.
Often these defects can be repaired with an interventional cardiology
procedure, using catheter-based technology. These interventional cardiology
procedures are done via a catheter that is equipped with a repair device,
inserted via a large vein in the groin and advanced to the site of the
defect. There are several types of repair devices but most operate like
an umbrella; they remain tightly folded until positioned properly and
then the device is opened in a way that blocks the hole. It is left permanently in place.
These minimally invasive procedures offer the advantages of easier and
quicker recovery, less bleeding and discomfort and faster healing than
Left Atrial Appendage Closure
Our hearts have a small, ear-shaped sac (an “appendage”) in
the muscle wall of the left atria (top left chamber of the heart). The
purpose of this appendage is not well understood but what doctors do know
is that people who have a condition called
atrial fibrillation are at risk for a blood clot (stroke) originating from this site. Since
the left atrial appendage serves no real function, a procedure called
Left Atrial Appendage Closure has been developed to seal off this part
of the heart so clots won’t develop or dislodge and travel to the
brain. Left Atrial Appendage Closure may be an option for patients with
atrial fibrillation who are not good candidates for blood-thinning drugs,
which are the first line of treatment for patients at risk for stroke.
The Left Atrial Appendage Closure procedure is done with a new device called
the Watchman (from Boston Scientific).
Coronary Fistula Closure
A coronary artery fistula is an abnormal connection (like a tube) between
a coronary artery and a heart chamber or other blood vessel. (Sometimes
there are several “fistulae.”) Coronary artery fistula is
rare but in certain situations it can cause problems. It may then requires
treatment to sever the connection so it cannot divert blood flow.
Most patients with coronary fistula require surgical treatment but some,
who are not good candidates for traditional open-heart surgery, can be
treated with catheter-based technology.
Transcatheter Paravalvular Leak Closure
Paravalvular leak (an incomplete seal at the site of a replacement heart
valve) is a not-uncommon potential complication of heart valve surgery.
Some paravalvular leaks are mild and can be monitored and handled without
need for an additional procedure. If repair is required, it can often
be done via a minimally invasive, catheter-based procedure.
For More Information
- For more information about the Torrance Memorial Structural Heart and Valve
Program, call 310-517-4790
Need a physician referral? Call our physician referral line 310-517-4700
or view our online
Want to learn more about the TAVR procedure available at Torrance Memorial?
click here to learn more about TAVR procedure. For additional information call 310-517-4790.