Atrial and Ventricular Septal Defect Treatment
The most advanced atrial and ventricular septal defect treatment, patent foramen ovale treatment and severe aortic stenosis treatment are provided by the region's top structural heart disease specialists and cardiovascular surgeons in state-of-the-art catheterization labs and operating rooms at North Shore-LIJ Health System's Cardiac Services.
Treatment for Atrial Septal Defect (ASD)
Small atrial septal defects (holes in the wall between the right and the left atrium) will often close spontaneously and require no intervention. Larger atrial septal defects may require closure, either in the cardiac catheterization laboratory or with traditional heart surgery. A septaloccluder device is inserted into the damaged area through a catheter. The device is then opened to effectively close the hole. The device remains in the heart permanently.
Treatment for Ventricular Septal Defect (VSD)
Ventricular septal defect is a hole in the wall, or septum, between the two pumping chambers of the heart. Some small VSDs will close spontaneously without intervention. Others will be adequately managed with medical therapy until they become smaller on their own. Larger ventricular septal defects will require surgical treatment. Left untreated, large ventricular septal defects can cause pulmonary hypertension.
Treatment for Patent Foramen Ovale (PFO)
Patent foramen ovale (PFO) is a defect in the septum (wall) between the two upper (atrial) chambers of the heart. PFO can be treated with medication or may require closure through cardiac catheterization. During cardiac catheterization, a special PFO closure device is used and expands its shape to straddle each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two upper chambers of the heart.
Patent foramen ovale (PFO) is a defect in the septum (wall) between the two upper (atrial) chambers of the heart. Specifically, the defect is an incomplete closure of the atrial septum that results in the creation of a flap or a valve-like opening in the atrial septal wall (see illustration). A PFO is present in everyone before birth but seals shut in about 80% of people.
Treatment for Severe Aortic Stenosis
There are a number of treatments for patients with severe aortic valve stenosis including traditional surgical valve replacement; and a new less invasive approach that replaces the valve using a catheter.
- Surgical Valve Replacement – This treatment for severe aortic stenosis uses traditional cardiac surgery techniques to repair heart valves. A damaged valve causes insufficient blood flow through the valves into the artery. Repair or replacement surgery can restore the blood flow.
- Transcatheter Aortic Valve Replacement (TAVR) – This less invasive aortic heart valve replacement procedure provides a new alternative to traditional open-heart surgery for select patients. The procedure is performed using a catheter that enters through the skin. An artificial aortic heart valve is attached to a wire frame (similar to a stent) and is guided by the catheter (a thin, flexible tube) to the heart. Once in the proper position in the heart, the wire frame expands, allowing the new aortic valve to open, begin to function immediately and alleviate the outflow obstruction.
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 mplant 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.
Participation in the
CoreValve US Pivotal Trial
requires coordination of a variety of North Shore-LIJ Cardiovascular specialties. Those specialties include:
- 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. These operating rooms combine the imaging capabilities of a traditional cardiac catheterization laboratory with the function of a cardiac operating room.