Structural Heart Disease and Heart Defects
Structural heart disease and heart defects refer to a defect or abnormality in the heart's valves or vessels. Some structural heart diseases are congenital (present at birth), such as atrial septal defects (ASD), ventricular septal defects (VSD) and patent foramen ovales (PFO), while other structural heart defects, such as severe aortic stenosis, can develop with age.
The multi-disciplinary team at North Shore-LIJ's Cardiac Services offers the latest diagnostic procedures and the most advanced non-invasive and invasive surgical treatments for patients with structural heart disease such as:
- Atrial Septum Defect – a hole in the septum (wall) that separates the two upper
(atrial) chambers of the heart
- Ventricular Septum Defect – a hole in the septum (wall) that separates the two lower (ventricular) chambers of the heart
- Patent Foramen Ovales – a structural heart defect that occurs when the small flap-like opening that separates the two upper (atrial) chambers of the heart prior to birth fail to seal after birth.
- Severe Aortic Stenosis – a buildup of calcium deposits on the aortic valve that causes narrowing and prevent the valve from opening properly
Utilizing our state-of-the-art facilities and technology, we can offer patients the widest array of treatment options and a superior patient experience.
Transcatheter Aortic Valve Replacement (TAVR)
High risk patients with severe aortic stenosis can now be considered for transcatheter aortic valve replacement (TAVR), a less-invasive procedure used to replace the aortic valve. Patients with severe aortic stenosis are generally older with multiple medical conditions which can put them at very high risk if traditional surgical procedures are performed. Previously these patients had little or no treatment options.
Traditional cardiac surgery involves an incision along the sternum (sternotomy) to access the heart. The TAVR procedure replaces a diseased aortic heart valve percutaneously – meaning through the skin – without a stermotomy and without surgical removal of the diseased valve.
The North Shore-LIJ Health System is a leader in the treatment of aortic valve disease, offering patients advanced aortic valve procedures that may not be available at other hospitals. Currently, North Shore-LIJ offers patients two options for transcatheter aortic valve replacement and the selection depends on the needs of the patient.
- Sapien Transcatheter Aortic Valve Replacement manufactured by Edwards Lifesciences – In 2011,
LIJ Medical Center was the first in Queens and Long Island to implant the FDA approved Edwards transcatheter valve
which is inserted through the femoral artery in the leg.
- Medtronic CoreValve US Pivotal Trial
– North Shore University Hospital and Lenox Hill Hospital are among 40 hospitals in the nation selected in 2010 to participate in this trial that evaluates the investigational aortic valve replacement procedure. Participants in trial benefit from four different valve sizes and three entry sites based on the anatomy and size of the patient's arteries.
Similar to a technique used to implant cardiac stents into clogged arteries, the TAVR procedure involves a physician guiding a catheter to the heart with an artificial valve attached. Using transesophageal echo and fluoroscopic imaging, the valve is checked for proper placement. The valve expands and is anchored inside the aorta and blood flow is restored. This cutting-edge alternative to open heart surgery is performed by a multidisciplinary team of interventional cardiologists, cardiothoracic surgeons and cardiac anesthesiologists, vascular surgeons, echocardiographers, physician assistants, nurses, OR staff and other healthcare professionals.
Both of the transcatheter valve replacement procedures offered at North Shore-LIJ involve a specialized team who utilize state-of-the-art technology to ensure optimal patient care. The North Shore-LIJ Health System has built several hybrid operating rooms for these procedures that combine the imaging capabilities of a traditional cardiac catheterization laboratory with the functionality of a cardiac operating room. This technology allows cardiac interventionalists and surgeons to collaborate on the most complex cardiac cases, and exemplifies North Shore-LIJ's commitment to the latest advances in cardiac care.
Participation in the Medtronic trial requires the close coordination of various North Shore-LIJ cardiovascular specialties including:
- Cardiac Surgery
- Interventional Cardiology
- Vascular Surgery
- Cardiac Anesthesiology
- Cardiac Imaging and Radiology
Several North Shore-LIJ hospitals have built state-of-the art hybrid operating rooms for these procedures that combine the imaging capabilities of a traditional cardiac catheterization laboratory with the functionality of a cardiac operating room.
North Shore-LIJ Health System is proud to be on the leading edge of medical breakthroughs in the treatment of severe aortic stenosis and other structural heart defects and diseases.